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Date Filed <br /> PREAPPLICATION CONSULTATION FORM <br /> REQUEST FOR APPROVAL - SUBDIVISION <br /> BURNETT LAND USE DEPARTMENT, BURNETT COUNTY GOVERNMENT CENTER <br /> Ark <br /> SIREN, WI 54872 /- <br /> APPLICANT -IT Ark T�VQccSF OWNER: U rlj /Oa A b <br /> i <br /> Phone: Phone: <br /> Location of Property: Yu <br /> Parcel No. <br /> Section___? Township Range Size <br /> Legal description attached. <br /> Names of Subdivision: 2-5 <br /> Land Surveyor preparing plat: rK Q ItS Q <br /> Number of Lots Current Zoning_ Proposed Zoning <br /> Will a Planned Unit Development be required <� <br /> Proposed water supply <br /> Proposed sewage system <br /> Proposed uses: Residential Commercial Park/Public <br /> Date (/ !� Q� Signature <br /> Fees Collected: <br /> J� 7 <br /> Date of Land Use Committee preliminary acceptance //_ Action d� <br /> Date of Land Use Committee final acceptance Action <br />