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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:Sloo.00+so.00/lot <br /> Owner: DA%AE_ vt£lE-i2, tAP►I�LNT I-LQ. �{�•K14• $2ucEbralu ME�ER� <br /> i <br /> Address: W)7> Sroti3DI4k �ob� <br /> FottJO. t•1t 1 c,543oj Phone: 95Z .qIZ .437-5 <br /> Ori Final Parcel Information 9 <br /> CZ•8-0112Yo-03 00o ZS .wn <br /> Parcel Identification#:0Z6- 4175-01 '700 Section 2(o Township yo Range ISI o <br /> oza- 417-5-01 goo <br /> Original Description(or attach copy): (fl <br /> C <br /> ?&M'r of x <br /> Go., ntitf..tEt.Tr" Loz- j + Sf�-rats 7-(o �.ntD 2/.1 <br /> -PAAM OE i- oaw1mawr LbT- 3 LGTlo1J 2-5 0 <br /> 4 Current Zoning: _ Floodplain Y/N: Yes Wetlands Y/N: 1 LS 'ata <br /> g <br /> Lake/River Classification: Name of Water Body: I I Cx IMckttz-Xt F LgK* <br /> re <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: krTALtAcy> <br /> n <br /> _ a <br /> Acres: I(.50Z. <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: SLE, A A4cb C_ fA <br /> Proposed access to public waters to be provided Y/N: Yr-.s o <br /> A <br /> If yes,describe access: SEL Q�p <br /> on <br /> 0 <br /> ➢ Does parcel meet Zoning Requirement Yes No <br /> N <br /> °e ➢ Does parcel require a Survey? Yes No ° <br /> e <br /> 0 <br /> Permit application,fees submitted? ❑ Amount,$ I <br /> �Q•DO Receipt# g0(p(o <br /> a <br /> No Date: <br /> ❑ Reconciles With Real Property Lister Yes Na' o <br /> e 111 <br /> a <br /> RIf not,explain: <br /> x, <br /> aVV 9) <br /> 000 <br /> Applicatio Approved / enied Reason for Denial: O o <br /> Land Use: Date: <br /> 2/18/2003 <br />