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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: s25.00+s5.00/1ot <br /> Owner: i(jo l�/me L79 telfA6�ff4E <br /> Address: /�6 356 lideu /' 1 eeeLd <br /> l -P,b.V lu <br /> r`, l .579 9,3 Phone: <br /> o ypoa <br /> _ Orieinal Parcel Information � <br /> Parcel Identification #: Z- — ection _Township /VN Ranger 3 <br /> Z <br /> Original Description (or attach copy): VVX 5 C yt/ <br /> 1Z <br /> J <br /> "O <br /> O <br /> 9 Current Zoning: Z Floodplain Ige 7 WetlandOF a <br /> 'v <br /> �✓r'� <br /> � <br /> • Lake/River Classification: — Name of Nater Body: P700 <br /> a, <br /> w <br /> New Parcel information J <br /> Proposed New Legal Description and Parcel Size: C5m <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: �G UN /CGC2 Cl 7 i I �C- <br /> Proposed access to public i aters to be provided 1 �'� UV C <br /> If yes, describe access: J Jul '1 M. <br /> f- <br /> OC1 <br /> Does parcel meet Zoning Requirements? )es No2p/�ING UNTy <br /> N <br /> ➢ Does parcel require a Surrey,? rD <br /> �• o <br /> °O a� 3 <br /> ➢ Permit application fees suhmitted? Amolort S r Receipt # ll/ � a <br /> w <br /> A <br /> 7 <br /> r <br /> Reconciles With Real Properly Lister Yes No Date: Q <br /> a <br /> If not, explain: <br /> 0 <br /> - W <br /> Application: Approved / Denied Reason for Denial: <br /> +� O <br /> Land Use: llate ( ` t��✓() <br /> 2/18/2003 <br />