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Pre-application Consultation Form <br /> Request For Approval- Subdivision <br /> Burnett County Land Use/Zoning Department <br /> Burnett County Government Center; Siren, Wisconsin <br /> Applicant: Wagner Surveying Associates'AAd Avenue ` Inc. Owner: DELL Ii U ED y <br /> r.VP.O. Box 89 j �- <br /> ..,_1._,_.. 1114 nn IM Ggcn� s�� 1 S lY �.e.•', L• R4 , <br /> '9cvnSTrra vQ <br /> 715=®8g=496 <br /> Phone: Phone: - L.) 5 <br /> Original Parcel Information: <br /> ➢ Location ofProperty,:: LD T5Kl�162c�SI , /�Lr6c�i <br /> ➢ Section: 33- 37 Township: T-g6AI Range: �� �'�/ Size: 5 ddre-_�5 <br /> ➢ Legal Description: l <br /> rr,,nn , It pr <br /> ➢ Current Zoning. K K Floodplain YIN.- 3-Jr Q `�1 Wetlands Y6 <br /> CL1j ss <br /> New Parcel Information: <br /> ➢ Land Surveyor Preparing Plat/Map: <br /> ➢ Number of Lots: 2 Proposed Zoning: SAAt <br /> ➢ Regional Flood Elevation: Klceh Il, esf- <br /> ➢ Will Access to Navigable Body of Water be Provided/Available, 1' !- <br /> ➢ Type of Access (Example: Outlot, Easement, Etc): L4 t Cd f- <br /> ➢ Proposed Water and Sanitary System: pt"tVa03 <br /> f� <br /> ➢ Proposed Use: Residential: x Commercial: Other: <br /> G <br /> Date: ? Signature: Mla 3f vz p off, <br /> / L- 2 a` <br /> For Office Use Only — Fees Collected: <br /> Date of Land Use Committee Preliminary Acceptance: — n—�'�� Action: <br /> Date of Land Use Committee Final Acceptance: Action: l <br />