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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: $25.00+$5.00/lot <br /> Owner: u t/ / �A40-*, SI Mello h <br /> Address: /23W. M.nneh4hq Pkwy Cat- 7147 <br /> /y);nnea oy li s M N Ss'l Phone: �0/ 2 • f 9T- Cot 0 <br /> Pte 1771 &M criar Rd banbuq W 5'230 <br /> Original Parcel Information A <br /> Parcel Identification #: 4/ft-07- too 4 Section�_Township 6 Range z <br /> Cif 2 <br /> Original Description (or attach copy): EQS i 2 7ft 6'„j � <br /> 0 <br /> 0 <br /> Z Flood lai N: WetlandsaN: <br /> Current Zo 'ng: R p <br /> V Qp L <br /> Lake/River Classification: Z Name of Water Body: <br /> m - <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: 4 .7 CJ'.*h G <br /> LAkr evrf�o< n-F A ne V, a0 A adU-d05 <br /> Acres: /• S V. <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided YqN: <br /> m <br /> If yes, describe access: o <br /> ➢ Does parcel meet Zoning Requirements? Yes No —0 <br /> N <br /> o ➢ Does parcel require a Survey,? }'e No c <br /> ° o <br /> ➢ Permit application fees submitted? Amount $ 5 Receipt # <br /> A <br /> d ❑ Reconciles With Real Property Lister Yes No Date: <br /> CL UZo <br /> If not, explain: <br /> o <br /> a <br /> � <br /> ) O <br /> Application: Approve I Denied Reason for Denial: / �4e (::�Lt'raaL' ej <br /> P'V (Lt LK B rm skDWiV <br /> Land Use: Date: <br /> 2/18/2003 <br />