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n1ie5i[neb 09:29 3492166 B C ZONING PAGE 01 <br /> Burnett County Subdivision Permit Application Fe"(must aoeompayform): <br /> and/or Pre-A 11Cat1011 �'Orm `9bdiviion w/o Survey; 510.00 <br /> PP Subdivision wt Survey:S 100.00+f 15.00/lot <br /> �t�r y I Ch1 Leak CA 6 <br /> Owner: Ili �u c�5 Sc- I1� !G:rt �jo LGA <br /> Address: <br /> Phone: <br /> oriefnal Parcel Information 3G Gy4cr 6 <br /> Parcel Identification N: — —C¢S.-t7 Section �k' Township 4c' Pi Range rS �V c <br /> Original Description (or attach copy): 5 cE <br /> 6` <br /> O <br /> y Current Zoning: Floodplain Y/N: <br /> 9 P Wetlands Y/N: + <br /> Lake/River Classification: , / <br /> Name of Water Body: Mor, ,Tr/ f(n J L <br /> a <br /> New Parcel Information <br /> nn <br /> Proposed New Legal Description and Parcel Size: -3 r. E <br /> 'of TTrkG fl 0 LN <br /> �N <br /> S � <br /> Acres: <br /> A <br /> Of parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: V/1, <br /> Proposed access to public waters to be provided Y/N: ? <br /> If yes,dperibe access: �A NG Sifn G 11v ESS n <br /> D Does parcel meet Zoning Requirements? Yes No <br /> ^. > Does parcel require a Survey? Yes No e <br /> 0 <br /> ➢ 'Permit application fees submitted? ❑ ° <br /> Amount$ Receipt <br /> ❑ Reconciles With Real Property ListerYea o0 <br /> No Date• y j <br /> If not,explain <br /> 09 <br /> WW <br /> s� <br /> Applica 'on: Approved / De led Reason for Denial: <br /> �0 0 <br /> 2118/2003Land Use: <br /> Date: <br />