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PRELIMINARY PLAT CHECKLIST <br /> // ,3 <br /> Date Application No. <br /> Subdivision v p/-1 ��C <br /> The following item(s) (does, does not) conform with the requirements f the <br /> Burnett County Subdivision Regulations. Those items not conforming a e <br /> explained on the attached page. <br /> Does Does Not Item <br /> 1• �/� Name of Subdivision (no duplication permitted) <br /> 2. !/ Locational Description <br /> 3• Name and address of owner, subdivider, surveyor a d <br /> engineer <br /> 4• / Proper scale <br /> 5. 1/ Date and North point <br /> 6. _ �{� Names of adjacent subdivision and owners <br /> 7. Zoning classification of all major percels and pr posed <br /> changes <br /> B• Location, width, and names of existing streets, <br /> / right-of-ways, easements <br /> 9• // Corporation, township, range, section lines <br /> 10. �/� Location of existing utilities including sewers, vater <br /> lines, and communication lines or poles <br /> 11: Layout, names and widths of proposed streets or easements <br /> and proper dedications <br /> 12. Layout and approximate demensions of all lots <br /> 13. V Designated wetlands and floodplains <br /> 14. ✓ Other information as specified <br /> 1 <br /> dd 40(5 S Title/P ition Signature I <br /> a) �« (e.SPl'ueo <br /> pws,.�1.4- c1s�a <br /> q �i <br /> l'4 �t- - <br /> /�/� fs 'X <br />