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Burnett County Subdivision Permit Application Fees(must accompany forth): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Survey:$100.00+$15.00/lot <br /> Owner. ]2,kLH C H C—LL. A OD OrN C--R-S <br /> Address: 39oz- WC--S- 415;Ti rlrstr— <br /> SiOUX FALLS i Soup+ DAKQrA Phone: 605 3G( ZZ7G <br /> A <br /> Original Parcel Information 3 <br /> Parcel Identification#: a 42. ZSZ-/ of Zoo Section 2--1 Township 3rd Range c <br /> Original Description (or attach copy): FArZr OF G o\/E12rJ M L=NT <br /> O <br /> a Current Zoning: 1Z 2 -zFloodplain Y/N: fJ Wetlands Y/N: �J <br /> g Lake/River Classification: <br /> Name of Water Body: IV/4 � <br /> m <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: T-.J0 3 Lar �t2T 1 Fi 2 D <br /> SUaVOY MAPS ( OurLcT To Dic� cfl l3 <br /> Woop 2ivG2 - Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: N o2TH S5 Ro fZLC j>1z 1✓ <br /> ttv <br /> Proposed access to public waters to be provided Y/N: �j <br /> If yes,describe access: <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N <br /> 0 <br /> e° ➢ Does parcel require a Survey? Yes No 9 <br /> � o <br /> ao e <br /> ➢ Permit application fees submitted? ❑ Amount$ Q.CJ U Receipt# `% ya y A <br /> a <br /> mp <br /> � ❑ Reconciles With Real Property Lister Yes No Date: <br /> a <br /> 6V If not,explain: <br /> 0 41 <br /> a cn <br /> w � <br /> J <br /> / L 0 <br /> Applicati Approv d / Denied Reason for Denial: �i77� eraedtl--�ji.�� 7 W <br /> z � <br /> C <br /> (' C <br /> Land Use: Date: <br /> 2/18/2003 <br />