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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, WI 54872 <br /> APPLICANT: OWNER: <br /> Zcc.Yb/ z Teras C�� ,P� <br /> d�oo� L.U1. <br /> Phone: 4-(08 - 7099 Phone: <br /> Location of Property: <br /> Parcel No. /� <br /> Section Township_ Range Size 3 , 3� A c, <br /> Legal description attached. <br /> Names of Subdivision: <br /> Land Surveyor preparing plat: G •fe- E Eaz.ioT7T <br /> Number of Lots I Current Zoning RR Z Proposed Zoning <br /> Will a Planned Unit Development be required Pio <br /> Proposed water supply <br /> Proposed sewage system TJQ»its <br /> Proposed uses: Residential LI/Commercial Park/Public <br /> Date '197/�-4 y'�- Signature <br /> Fees Collected: <br /> Date of Land Use Committee preliminary acceptance Action <br /> Date of Land Use Committee final acceptance Action <br />