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Pre-application Consultation Form <br /> Request For Approval — Subdivision <br /> Burnett County Land Use/Zoning Department <br /> Burnett County Government Center; Siren, Wisconsin <br /> Wagner Surveying Associates, Inc. Q <br /> Applicant: 26745 Lakeland Avenue N. Owner: Robes-fi <br /> P.O. Box 89 <br /> Webster, Wisconsin 54893 25 a ylv P,'kp &tid 1?6ad <br /> 715-866-4295 <.Y�� &) i <br /> 5y8q,3 <br /> Phone: Phone: _ q — 553-3 <br /> Original Parcel Information: <br /> ➢ Location of Property: G. k . y <br /> ➢ Section: a5 Township: 39I Range: l(P W Size: 1. 9S aCkzo <br /> ➢ Legal Descripf-- Al <br /> rr L ¢ EKC <br /> ➢ Current Zoni opeA loodplain Y fWetlands Y& <br /> New Parcel Infor <br /> ➢ Land Surveyor Preparing Plat/Map: aiz- k E K2ci tcS.-e <br /> ➢ Number of Lots: Proposed Zoning: <br /> ➢ Regional Flood Elevation: A <br /> ➢ Will Access to Navigable Body of Water be Provided/Available, Y N <br /> ➢ Type ofAccess (Example: Outlot, Easement, Etc): <br /> ➢ Proposed Water and Sanitary System: pri i✓4f( c (1i�, N <br /> ➢ Proposed Use: Residential: X Commercial: Oth er.P'ji-iji hz 'Pool <br /> <Ojrv/� 001V <br /> Date: S- i- 01 Signature: } OWA'e <br /> For Office Use Only — Fees Collected: p <br /> Date of Land Use Committee Preliminary Acceptance: Action: <br /> Date of Land Use Committee Final Acceptance: Action: <br />