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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Subdivision w/o Survey: $10.00 <br /> n pp Subdivision w/Survey:$IOO.Op+$15.00/lot <br /> Owner: ICoNALD I Webb it Sleel, <br /> 'v <br /> Address: 21V �pt/ // G / q 3 <br /> Ct `ect' LAk< yvlS s4Ut'S Phone: /Il r��� dI�7 e <br /> Orieinal Parcel Information //// <br /> Parcel Identification#: 020A321—o2-2ooSection 21 Township YU Range 16 <br /> Original Description (or attach copy): F X J 1'11 j p% PAFC a jS t A- 6OVi C•f l p <br /> if 14134a ( N y d f <br /> D« Dic #3S36Sz Doc h/a �w lots br,+ cwr�r/r <br /> D MAP 1G4E RF Pp /14 <br /> m Current Zoning: RR' z Floodplain&": Wetlandsl'N: GAkY 0� <br /> Lake/River Classification: 2 Name of Water Body: rr1_e ASif ra d 4 <br /> New Parcel Information c p <br /> Proposed New Legal Description and Parcel Size: C Sm t) 1 e XI's f ansr /?4. r!� <br /> cA <br /> Acres: <br /> (If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 6Xfr FIyC- <br /> Signature of Applicant: Date: ,)O, <br /> ➢ Does parcel meet Zoning Requireme ts? Yes No <br /> 0 <br /> �• ➢ Does parcel require a Survey? Yes No <br /> 00 py Q 0 <br /> ➢ Permit application fees submitted? ❑ Amount$�' Receipt# <br /> e <br /> A <br /> a <br /> ❑ Reconciles with Real Property Lister Yes No Date: C i <br /> a � <br /> If not,explain: <br /> o � � <br /> a L <br /> Application pprove Denied Reason for Denial: b <br /> N <br /> Land Use: Date: [t7' <br /> 0 <br />