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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 /> SIREN, MI 54872 <br /> APPLICANT: OWNER: G�/AeLES ��SSO <br /> Phone: gfolo - 429� Phone: <br /> Location of Property: GovEeti/n1si�T- /-0725 -- <br /> Parcel No. <br /> Section 3/ Township O Range //!fP Size g ,4GP�5 <br /> Legal description attached. 1 <br /> Names of Subdivision: <br /> Land Surveyor preparing plat: <br /> l <br /> �;. Number of Lots�_ Current Zoning Proposed Zoning <br /> yt <br /> Will a Planned Unit Development be required <br /> n- <br /> Proposed water supply 111,ei t/,4TE �X i�/✓�� -- <br /> Proposed sewage system <br /> Proposed uses: Residential_ Commercial Park/Public <br /> Date _6//7/17C? Signature — <br /> Fees ollected: <br /> Date of Land Use Committee preliminary acceptance Action <br /> . I <br /> Date of Land Use Committee final acceptance Action <br />