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llA'1'� <br /> PREAPPLICATION CONSULTATION FORM <br /> REQUEST FOR APPROVAL - SUBDIVISION <br /> BuRNETT COUN'T'Y LAND UgE/ZONING DEPART TENT <br /> BURNETT .COUNTY GOVMMENT CENTER, SIREN, WI 54572 <br /> APPLICANT: OWNER: GREG �Talilis h <br /> Waver Surve in Associates Inc. pip y35- 77 <br /> a e an venue <br /> P.O. Box 89 FSH!{JW�- �/IAilSoKs <br /> Webster, Wisconsin 54893 <br /> PHONE: 715.866-4295 PHONE: <br /> ORIGINAL PARCEL OF INFORMATION: <br /> LOCATION OF PROPERTY <br /> SECTION I TOWN—AL. RANGE �S SIZE <br /> LEGAL DESCRIPT N C <br /> — CURRENT 2::;;; �R 3 OODPLAIN YH� WETLANDS Y(f <br /> NEW PARCEL INFORMATION: <br /> — LAND SURVEYOR PREPARING PLAT/MAP <br /> — NUMBER OF LOTS 3 PROPOSED ZONING ff1� <br /> - REGIONAL FLOOD ELEVATION ,/vA <br /> - WILL ACCESS TO NAVIGABLE BODY OF WATER BE PROVIDED/AVAILABLE Y/91-,_ <br /> - TYPE OF ACCESS (EZ- OUTLOT, EASEMENT, ETC. ) N6A-f <br /> Q <br /> - PROPOSED WATER AND SANITARY SYSTEM / K/"'9Ter <br /> - PROPOSED USE: RESIDENTIAL tVifjM C- COMMERCIAL OTHER <br /> DATE ! .�D ff SIGNATURE <br /> FEES COLLECTED: <br /> DATE OF LAND IISE COMMITTEE PRELIMINARY ACCEPTANCE ACTION <br /> DATE' OF LAND USE COMMITTEE FINAL ACCEPTANCE ACTION <br />