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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Survey: $25.00+$5.0011ot <br /> Owner: DP'0 6L.0c >=.:iL_„J <br /> Address: Z 35 s� -qz ttosoe3 1zD <br /> 6 t2 t NTS 130 P2 6, In/L 0 Phone: 71 S 63 2z 34— <br /> Original Parcel Information A <br /> Parcel Identification#: O ya-`•j100 - 03 -36( ection Z 7 Township 3 8 Range I 3 <br /> Z <br /> 0 <br /> Original Description(or attach copy): LoT l2- KLGM SS WOOD L-P,r G <br /> 00 <br /> 1 v�✓ AMD1 0 tJ <br /> 0 <br /> Current Zoning: �(L ( Floodplain Y/N: yG-5 Wetlands Y/N: Yes <br /> .fl <br /> Lake/River Classification: CcASS Name of Water Body: klooO LAXC- <br /> m <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: .3 Lor c Srv/ V I <br /> Acres: �c2t7S <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 1./000 Z_/�X& V/G-yJ D2>1/5 <br /> Proposed access to public waters to be provided Y/N: d A/ o A✓G L eT O <br /> w <br /> A <br /> If yes,describe access: 'Erx/srin/6 rsJG,= <br /> 1 <br /> ©c, <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N <br /> °o ➢ Does parcel require a Survey? Yes No 0 <br /> 0° o <br /> ➢ Permit application fees submitted? I Amount$ 416 <br /> /� U Receipt # <br /> A <br /> , <br /> a <br /> Reconciles With Real Property ListerYes No Date: Q <br /> If not,explain: <br /> 0 <br /> n. <br /> h <br /> Q <br /> Application: Approved / Denied Reason for Denial: <br /> t <br /> Land Use: Date: t-7 <br /> 2/18/2003 <br />