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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: <br /> and/or Pre-Application Form 00 <br /> PP Subdivision w/Survey:$100.000.00+$15.0011ot <br /> Owner: _ljFiznl4 i7F r T� L yon✓ 7'KusT <br /> Address: 3'f94W1V Lipjt-'Oenl L4yE <br /> h/�r��E /ZE N r✓C`'I� <br /> Gi44E Vi L 1 r9 1 L . 4"0'ep* 0 Phone: oSL 3jSo4o <br /> G�cc -,�s ssaf 4883 ,� <br /> Original Parcel Information <br /> Parcel Identification#: o a.o 4303o 3 3 a aSection 3 Township 40 Range 140 <br /> c <br /> Original Description (or attach copy): Gi o T Go r— <br /> �D <br /> O <br /> Current Zoning: 2 Q Z Floodplain Y/N: ? Wetlands Y/N: <br /> V• Lake/River Classification: Name of Water Body: Lv111C 1,44-A <br /> o rp <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: f1Tr,4444e'D (� <br /> Acres: t l <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: ,411/9 <br /> d <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: 4-1 <br /> J <br /> a <br /> o <br /> ➢ Does parcel meet Zoning Requirements? es No <br /> N c <br /> °o ➢ Does parcel require a Survey? Yes No B <br /> ➢ Permit application fees submitted? ❑ Amount S Receipt# <br /> x <br /> r G <br /> ❑ Reconciles With Real Property Lis te Yes No Date: a <br /> a <br /> t <br /> o If not,explain: <br /> a l,J <br /> Vi <br /> 1 <br /> Q <br /> W <br /> Application: rov Denied Reason for Denial: W <br /> O <br /> Land Use• r Date: <br /> 2/18/2003 <br />