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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:Sl00.00+$15.00/lot <br /> Owner: Cram-y -:Sim . <br /> Address: M1,401 01 6 ELG s t &,a T61 Z 4 kcE <br /> S-F�E:z t ifs 5--4-Sm 1 Phone: <br /> A <br /> Original Parcel Information <br /> Parcel Identification#: =5 4116 e4 yro Section 16 Township 4E) Range /-I-- e <br /> Original Description(or attach copy): Lam z <br /> Y6_ <br /> > Current Zoning: C' 1 Floodplain Y6T Wetlandolft <br /> C� <br /> Lake/River Classification: Alk Name of Water Body: /\4 '4 . p <br /> » —c <br /> New Parcel Information <br /> to <br /> Proposed New Legal Description and Parcel Size: rym <br /> Acres: B, 6 , o. 7-Auras <br /> (if parcel Is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: �1�SNt�r tir To 07x1 S A } // <br /> Proposed access to public waters to be provided V <br /> If yes,describe access: (N <br /> Chi <br /> ➢ Does parcel meet Zoning Requirents? Yes No C, <br /> D Does parcel require a Survey? Yes No e <br /> e <br /> Permit application fees submitted? O Amount S Receipt# <br /> a <br /> 0 <br /> O Reconciles With Real Property Lister Yes No Date: 9) <br /> If not,explain: <br /> 0 <br /> Apptic on: Approved / nied Reason for Denial: 1-1-/) 411ej C) <br /> Ike me It> CPf o vy l 4'jy1-( SG� <br /> Land Use: %) Date• <br /> 2/18/2003 <br />