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r� <br /> Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Surver.. $25.00+$5.00Aot <br /> Owner: JD�l� tTlL2T� <br /> Address: 7945 Sf ,af, Ht„,, 77 <br /> NAFROAle W U S f,00 Phone: (;S6_ 700 <br /> Original Parcel Information A <br /> Parcel Identification#: 3 2—s 2�'�)_zW Section Z9 Township y, ,v Range 3 <br /> z <br /> Original Description (or attach copy): N W Y4 NE V4 Ly)h.V 1#v14 # Y .37# <br /> V. SS2 P 468 Aw 17at,r 2 <br /> 0 <br /> Current Zoning: Floodplain / Wetlands Y/N: 7 _ <br /> m <br /> Lake/River Classification: Name of Water Body: <br /> 0 <br /> New Parcel Information J �/ <br /> Proposed New Legal Description and Parcel Size: 2 �-�f e•rM V ���`t <br /> A c-,*c___V S.Y c Ac. s <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Ex)s L A A-h., rad o )rA*W44- <br /> Proposed access to public waters to be provided Yd p <br /> If yes,describe access: g <br /> ➢ Does parcel meet Zoning Requirement Yes No <br /> N <br /> ➢ Does parcel require a Survey? Yes No c <br /> Cd✓ 3 <br /> ➢ Permit application fees submitted? Amount$ 35 Receipt# <br /> A <br /> r � <br /> Reconciles With Real Property List Yes No Date: O <br /> a <br /> If not, explain: (� <br /> 0 1 <br /> a <br /> H <br /> W <br /> Application: Approved / Denied Reason for Denial: <br /> Q <br /> Land Use: f , b'j <br /> • - Date. - �... . ,, <br /> �tx h Vii:«§' h•� <br />-2/18/2003 <br />