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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: $25.00+$5.00I1ot <br /> Owner: jky-p- ounce '0A{1--1 , <br /> Address: a qaq 0 Uj O �yu W �1 <br /> U�k , UOJ--- 514 S`7 �i Phone: <br /> Orieinal Parcel Information I <br /> -C1/ '/s-6o1^0200 3 <br /> Parcel Identification#: G Section e-�O TownshiW-0 Rangel!IL z <br /> I/ <br /> Original Description (or attach copy): L / RlQ Ce�G - / 1�� `'d/� <br /> L'1Ce Se� <br /> s <br /> O <br /> Current Zoning: Floodplain Y/N: /v Wetlands Y/N: �V <br /> Lake/River Classification: Name of Water Body: <br /> m <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: C-Q-ny <br /> U ACS <br /> Acres: L.4 t' d - /. OV O-r-- <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 6->1- C� l�- <br /> Proposed access to public waters to be provided v <br /> A <br /> If yes,describe access: ll� <br /> ➢ Does parcel meet Zoning Requirements? Yes No 0 <br /> °o ➢ Does parcel require a Survey? Yes No �a n <br /> 0 <br /> oa <br /> ➢ Permit application fees submitted? Amount$ IM, 02) Receipt # c <br /> A <br /> �] Reconciles With Real Property Lister Yes No Date: <br /> a <br /> 1� <br /> If not, explain: i <br /> o � <br /> Application• Approved Denied Reason for Denial: ip <br /> �J <br /> Land Use: C11lhh/ Date: J �Q <br /> 2/18/2003 V <br />