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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:$100.00+$15.00/lot <br /> Owner: W \LU A:M P_AJrC pry p1ND h!1 tv2C�LLA >K A/2Tl <br /> Address: 6-76+ 3loOtk ST- <br /> NarLT'+ 32WC 14 M 1J S5d5lP Phone: 6Sl E74 1a 3z <br /> Orl¢inal Parcel Information <br /> ZOO 'a <br /> Parcel Identification#: (00-L i(034 03 Section 34 Township 3-7 Rangel 9 z <br /> 0 <br /> Original Description(or attach copy): PAd t Cu�c I r) S (4 c1 14 <br /> A-1?A-c Nip <br /> ID <br /> --P— <br /> O <br /> o Current Zoning: A-- Floodplain Y/N: 00 Wetlands Y/N: � o <br /> Lake/River Classification: Name of Water Body: <br /> m , <br /> New Parcel Information 3 <br /> Proposed New Legal Description and Parcel Size: 3 k C PG- PAa2ccirS <br /> Bal GSM <br /> Acres: �1 <br /> fi <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Lo T— t t3 y 1EA5 1v\U�\J 1✓ <br /> Proposed access to public waters to be provided Y/N: n)o p <br /> m <br /> R <br /> If yes,describe access: <br /> V) <br /> N ➢ Does parcel meet Zoning Requirements? Yes No <br /> Ll <br /> Yes <br /> ➢ Does parcel require a Survey? No c7 <br /> o <br /> 00 � <br /> ➢ Permit application fees submitted? ❑ Amount$ Receipt# <br /> R <br /> A <br /> Z <br /> r ?� <br /> ❑ Reconciles With Real Property Lister Yes No Date: <br /> a <br /> If not,explain: 93 <br /> a W <br /> h <br /> Applicata Approved / enied Reason for Denial: Cn1 <br /> 0 <br /> Land Use• Date• <br /> 2/18/2003 <br />