Laserfiche WebLink
01/20/1994 08:29 17158664206 WAGNER SURVEYING PAGE 02 <br /> Burnett County Subdivision Permit Application Fees(mustaccompany form): <br /> and/or Pre-Application <br /> Subdivision /osurvry: 000.00 <br /> pp Subdivision NdSurvey:E100.00+515.00/lot <br /> Owner. 14gW mAkegAW - Kirlee�v am-5e4- E <br /> Address: bJq jr Pd. '76 1056 13214d W3'/NX 349-2Yy£S 3 <br /> �iIQ11/Yll WI MM— 6Wtje1 A J 51 ho e: -X55-roo�35 <br /> 618-33515-05240 Orr¢inal Parcel Information <br /> Parcel Identification k: 418-3335- 65300 Section 35 Township 39 Range <br /> Original Description (or attach copy): Q 1 L OF LdT l6 ted qv f O <br /> f <br /> J o 9 Rp be+-T ,C9a ch So <br /> Curtest zesting. U Al ZCxe of Floodplair&Y N: WeHan <br /> LakelRiver Classification: C/.Ass1 Name of Water Body: R' <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: C.51m <br /> Acres: �• N <br /> (If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br /> Propoaad access to public road: 5T r D <br /> 0 <br /> d <br /> Signature of Owner. „e.�. ��) Date: 6- O '7 <br /> )► Requirements? Yes NO <br /> 0 <br /> ➢ Does parcel require a Swvey? C-� Yes Ner n <br /> 0 <br /> ➢ Permit application fees submitted? ❑ Amount 5 Receip 0 <br /> C <br /> r'e <br /> ❑RYecascifas with Real Property Lister Yes No Date: a <br /> n <br /> If sat,explain: <br /> Apptlwtloa: Approved / Denied Reason for Denial: <br /> LandU e: Date: <br />