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Burnett County Subdivision Permit Application Fees(mu I accompany form): <br /> and/or Pre-Application Form Subdivisi n w/o Survey: $10.00 <br /> nn PP Subdivisi n w/Survey:$100.00+$15.00/lot <br /> Owner: /J G/ NKe- <br /> 35 <br /> Address: 2W96 OLD <br /> Phone: <br /> 04 -Zy77-0Z--/00 OOviuinal Parcel Information '/ <br /> Parcel Identification #: �(I�i-z`/2'�' 02-- 1/06 Section - // Township Range/1" <br /> Original Description(or attach copy): Sit) yil Stu t/ <br /> f <br /> 0 <br /> A <br /> Current Zoning: 11 u2 Floodplain 6: Wetland Y : <br /> Lake/River Classification: CLASS 3 Name of Water Body: L000 4/V?/C' <br /> New Parcel Informatioon�, <br /> Proposed New Legal Description and Parcel Size: L4 <br /> Acres �� OJ <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> y� <br /> 11 <br /> Proposed access to public road: 6 LQ 35 ,1 6a <br /> �� __ "- j d <br /> Signature of Owner: �b� Dat • <br /> f� <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> 0 <br /> °g• ➢ Does parcel require a Survey? Yes No <br /> ➢ Permit application fees submitted? ❑ Amount$ Rece' t# 9 <br /> A <br /> r ;p <br /> ❑ Reconciles with Real Property Lister Yes No Date: <br /> a <br /> If not,explain: <br /> 0 <br /> a <br /> w <br /> Application: Approved / Denied Reason for Denial: <br /> Land Use: Date: <br /> i <br />