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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:$100.00+$15.0onot <br /> Owner: J JAtJ �TorZV_WtJD <br /> Address: 4 co 93 CT-If C� <br /> DP* Svrzy ln/L 54-83 o Phone: 866 ¢ZSS <br /> m <br /> Orieinal Parcel Information 'g <br /> Parcel Identification#: 01-L. 4•Z 6G ofI ooSection 10 Township�Range 1 S o <br /> Original Description (or attach copy): <br /> WEST- Zac OF (f,L_ I d <br /> J <br /> 0 <br /> > Current Zoning: Re./ Floodplain Y/N: tj Wetlands Y/N: /J <br /> q• Lake/River Classification: 3 Name of Water Body: LOWS(? LaoiJ Lif A <br /> m � <br /> e <br /> New'Parcel Information ° <br /> tr <br /> Proposed New Legal Description and Parcel Size: ,4 atJs LoT <S n, o F <br /> J <br /> Ar/ t-7)0SrING PArzC6 _ <br /> Acres: 4-,83 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: N�q <br /> � �/� d <br /> Proposed access to public waters to be provided Y/N: r—� A <br /> If yes,describe access: <br /> ➢ Does parcel meet Zoning Requirements Yes No <br /> N � n <br /> ➢ Does parcel require a Survey? Yes No e <br /> ao e <br /> ➢ Permit application fees submitted? O Amount S Receipt# <br /> x <br /> r � <br /> ❑ Reconciles With Real Property Lister Yes No Date: <br /> C6 <br /> If not,explain: <br /> o <br /> 'aa S <br /> w r <br /> O <br /> i <br /> Applicatio . Approv / Denied Reason for Denial: O <br /> G <br /> LandUse: Date: �Q <br /> 2/18/2003 <br />