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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: $25.00+$5.0011ot <br /> Owner: Okk o '�'OL <br /> Address: y7 ell� Sw? Phone: ��/ `� "/V F – 0 <br /> Original Parcel Information A <br /> Parcel Identification #: Section 3a-• Township 7M Range ✓V 3 <br /> z <br /> Original Description (or attach copy): <br /> Alt ly Al E 'N <br /> QJ <br /> O <br /> a <br /> Current Zoning: /� Floodplain Y� Wetlands Y� <br /> Lake/River Classifi"tion: Name of Water Body: — p <br /> o <br /> New Parcel Information c7 <br /> a <br /> Proposed New Legal Description and Parcel Size: <br /> Acres: <br /> (If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 141n GWS <br /> Proposed access to public waters to be provided Y/N: o <br /> A <br /> If yes, describe access: W <br /> W <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> a . <br /> °o ➢ Does parcel require a Surrey? Yes No c <br /> 7 3 <br /> ao <br /> ➢ Permit application fees submitted? ❑ Amount S Receipt # e <br /> A <br /> ro <br /> x <br /> ❑ Reconciles With Real Property Lister Yes No Date: o <br /> a �J <br /> 0 <br /> If not, explain: <br /> o W <br /> a <br /> W <br /> H <br /> Applicatio Approve / Denied Reason for Denial: <br /> Land Use: Date: 3 <br /> 2/18/2003 <br />