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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:$100.00+$15.00/lot <br /> Owner: jouGta.S WILsKC <br /> Address: 3'7 3<09 tJ S&ozu.An1D RP <br /> 5TU"66 n1 LPIC E M til 5 5 78 3 Phone: 2- l 8 37 Z 8 9 1 1 <br /> A <br /> Orieinal Parcel Information 3 <br /> M <br /> Parcel Identification#: 0o8 'L//8 Of- 700 Section IS Township 3 8 Range o <br /> Original Description(or attach copy): Ptt2T op C-j- L Ce <br /> �Q <br /> O <br /> 9 <br /> y Current Zoning: 12..12 Floodplain Y/N: 4 Wetlands Y/N: <br /> •o <br /> 'o <br /> m Lake/River Classification: 1%j Name of Water Body: <br /> 0 <br /> R <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> Acres: 3 + <br /> — re <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> d <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: Di rzT-cT' Qj <br /> b <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N e <br /> ➢ Does parcel require a Survey? Yes No g <br /> 070 g � <br /> ➢ Permit application fees submitted? ❑ Amount$ _ Receipt# <br /> u <br /> r <br /> ❑ Reconciles With Real Property Lister Yes No Date: <br /> a <br /> If not,explain: <br /> o Q10 <br /> a <br /> O <br /> S <br /> Applicatio Approved / enied Reason for Denial: <br /> c <br /> Land Use: Date: �� fl S <br /> 2/18/2003 <br />