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DATE <br /> PREAPPLICATION CONSULTATION FORM <br /> REQUEST FOR APPROVAL - SUBDIVISION <br /> BURNETT COUNTY LAND USE/ZONING DEPARTMENT <br /> BURNETT COUNTY GOVERNMENT CENTER, SIREN, WI 54872 <br /> APPLICANT: _ M t e-a A m- - tJo rz-ro eel OWNER: q;�'o tJ (:fo L'e;!Y <br /> �.0 3� Cove-�r•� A 3o i s �.-r. �..� . A <br /> LJnaor�l�2, ��GI s�$ol VC�6�S'ref;e 54893 <br /> PHONE: -1 15 -Co3 5 - 7 P^3 PHONE: -1 1 S- ( 3 S - Z 338 <br /> ORIGINAL PARCEL OF INFORMATION: <br /> _. <br /> 67-0%1 <br /> - LOCATION OF PROPERTY lCc a-r-rAC-A4eP esM . , (p -rS <br /> - SECTION t g TOWN AO t-� RANGE 114 \A) SIZE 3.698 aczeS <br /> - LEGAL DESCRIPTION L. 5 (o, S 86 e-s'kA <br /> - CURRENT ZONING F-R-1 FLOODPLAIN Y/N �_ WETLANDS Y/N <br /> G LAf,s Z L.4v-s <br /> NEW PARCEL INFORMATION: 1 <br /> - LAND SURVEYOR PREPARING PLAT/MAP lu► • t� o rz To �� <br /> - NUMBER OF LOTS Z PROPOSED ZONING <br /> - REGIONAL FLOOD ELEVATION ? <br /> - WILL ACCESS TO NAVIGABLE BODY OF WATER BE PROVIDED/AVAILABLE Y/N <br /> - TYPE OF ACCESS (EB. OUTLOT, EASEMENT, ETC. ) <br /> - PROPOSED WATER AND SANITARY SYSTEM TkIvAar6 <br /> - PROPOSED USE: RESIDENTIAL COMMERCIAL �_ OTH <br /> Lei Z. Lo-r 1 Cj rl <br /> DATE -1 - ZZ-98 SIGNATURE <br /> FEES COLLECTED: <br /> DATE OF LAND USE COMMITTEE PRELIMINARY ACCEPTANCE ACTION <br /> DATE OF LAND USE COMMITTEE FINAL ACCEPTANCE ACTION <br />