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Burnett County Subdivision Permit Application Fees(must accompany forth): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Forms Subdivision w/Survey: 525.00+S5.00Aot <br /> Owner: <br /> Address: <br /> Phone: <br /> / /,jOriainal Parcel Information / n <br /> Parcel Identification#: 63`t'—`l ��16l 3CXDI Township Ye Range /7�"L' 3 <br /> r p z <br /> Original Description (or attacht <br /> copy): Crki S �t 0'14 r f rco <br /> 1 .. <br /> 5 E!i ftpv. L,f 1 of <br /> V Current Zoning: ' Floodplain Y� � <br /> Wetlands Y <br /> M• Lake/River Classification: _ Name of Water Body: <br /> e <br /> w <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: f le6 fu-�C 0 <br /> �at C`S r-n lit' fol <br /> Acres: 71741 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C . T ��)< .6�-`/ I-ee �jOtLt4 <br /> Proposed access to public waters to be provided Y61: d <br /> R <br /> A <br /> If yes,describe access: <br /> Does parcel meet Zoning Requirements? Yes No <br /> N <br /> ➢ Does parcel require a Survey? Yes No c <br /> 7 � 3 <br /> ➢ Permit application fees submitted? Amount$ �3 d'6�D Receipt# 7 r C <br /> A <br /> ❑ Reconciles With Real Property Lister Yes No Date: P <br /> If not,explain: <br /> o � <br /> a "C <br /> Applicata n: Approved a Denied Reason for Denial: <br /> 0 <br /> I <br /> Land Use: Date: 3 <br /> 2/18/2003 <br />