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Date Filed <br /> JAN <br /> PREAPPLICATION CONSULTATION FORM ` l <br /> REQUEST FOR APPROVAL —. SUBDIVISION <br /> BURNETT LAND USE DEPARTMENT, BURNETT COUNTY GOVERNMENT CE <br /> SIREN, WI 54872 TT ll <br /> APPLICANT: WA6iuo -SuRysvi,yF oc, OWNER: L, GRE60RV JAhson <br /> V 35 d 77 <br /> Wt6tt�, 04fluxy Wis. <br /> Phone: Phone: GSC -3292 <br /> Location of Property: <br /> NE NW d Allo NE Parcel No. <br /> Section 23 Township 41 Range Size Q. <br /> Legal description attached. <br /> Names of Subdivision: C S' M <br /> Land Surveyor preparing plat: MARS E. AIM AF <br /> Number of Lots Current Zoning C4rhfimm;l Proposed Zoning JAA, <br /> Will a Planned Unit Development be required <br /> Proposed water supply EAllur FI-/1"gn <br /> Proposed sewage system Ek,sf'fi, 6/1"m <br /> Proposed uses: Residential Commercial Park/Public <br /> Date A}/9 Signature //!j g _ <br /> Fees Collected: <br /> i <br /> Date of Land Use Committee preliminary acceptance / �-9/ Action / �7X1eCJj <br /> - rr <br /> Date of Land Use Committee final acceptance Action <br /> 4 <br />