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Date Filed <br /> PREAPPLICATION CONSULTATION FORM <br /> REQUEST FOR APPROVAL - SUBDIVISION <br /> BURNETT LAND USE DEPARTMENT, BURNETT COUNTY GOVERNMENT CENTER <br /> SIREN, WI 54872 <br /> APPLICANT: !Ilrv_ OWNER: <br /> �i-/Ut-/t <br /> Phone: 0 (g 6 g2C/_C Phone: I Z 384 --242-1 <br /> Location of Property: G-1 7- - G 1.3 - CL 1i <br /> Parcel No. <br /> Section Z4 Township _ Range_ Size 2d AC , <br /> Legal description attached. <br /> Names of Subdivision: 3 C S- 1h j <br /> Land Surveyor preparing plat: M A KH kj(p ujF <br /> Number of Lots lU Current Zoning Proposed Zoning 111^! <br /> Will a Planned Unit Development be required ^/o <br /> Proposed water supply �KIVR r-6- <br /> Proposed <br /> GProposed sewage system PPI ilAZ,6 <br /> Proposed uses: Residential k Commercial Park/Public <br /> Date 7 1qt Signature G% 'e <br /> Fees Collected: <br /> Date of Land Use Committee preliminary acceptance Action <br /> Date of Land Use Committee final acceptance Action <br />