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Burnett County Subdivision Permit Application Fees (must accompany form): <br />L Subdivision w/o Survey: $10.00 <br />and//or Pre -Application Form Subdivision w/ Survey: $25.00 + $5.00/1ot <br />rn U O S <br />Owner: \JUt° leoJa <br />Address: Il 7 9 eo Rd '67 ON COMPUTER/SCANNED <br />Phone: <br />Original Parcel Information <br />A <br />Parcel Identification #: 2" Yd-ly Z� d d39 Section Zai Township t/e Range <br />^' <br />Original Description (or attach copy): dlr V / '2 1/8 <br />z <br />0 <br />6, L y <br />J <br />• <br />Current Zoning: U food ain Y@,,) Wetlands YC <br />o <br />Y <br />b <br />�• <br />Lake/River Classification: Name of Water Body: <br />_ <br />New Parcel Information <br />V I <br />���% V 'n <br />Proposed New Legal Description and Parcel Size: <br />Acres: A5 <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: C, / • �. /� t/ <br />Proposed access to public waters to be provided Yo <br />If yes, describe access: <br />v <br />➢ Does parcel meet Zoning Requirements? Yes No BURNE <br />TT COUNTY <br />Yes <br />➢ Does parcel require a Survvy? No ZONING <br />A Permit application fees submitted?] Amount $ Receipt # o (O <br />It not, explain: <br />v <br />i <br />Application: A proved De d"_. eason for Denial• <br />1W 7L <br />Land Use: Date: l <br />Q <br />2/18/2003 <br />