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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision wlo Survey: $10.00 <br /> and//or Pre-Application Form :001101tOwner: �rf <br /> '9u2U -'p <br /> Address: <br /> Phone: z <br /> Orioinal Parcel Information <br /> U�1 <br /> Parcel Identification#: O33-5336_t)a x0Section 35 f Fownship Range 0i <br /> Original Description(or attach copy): 3� <br /> y GlJ l dee <br /> a <br /> 3 Wetlands Y : <br /> n Current Zoning: /� Floodplai <br /> .. Lake/River Classification: Name of Water Body: AU 'I � <br /> New Parcel Inform/lation <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: IJU/1/Q�I.GrZL `�/ /Zl <br /> v <br /> �� <br /> Signature of Owner: Date:Z�bl�07 <br /> SvrSe <br /> ➢ Does parcel meet Zoning Requirements? Yes No C <br /> 0 <br /> ' ➢ Does parcel require a Survey? Yes No n <br /> � 3 <br /> ➢ Permit application fees submitted? ❑ Amount 3 /J U- D Receipt# <br /> e <br /> A <br /> 1 <br /> ❑Reconciles with Real Property Lister Yes No Date: <br /> C6 <br /> if not,explain: <br /> ul <br /> 3 w <br /> N � � <br /> 0 <br /> Application: Approved / Denied Reason for Denial: <br /> Land Use: <br /> Date: 0 <br />