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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: $25.00+55.00/lot <br /> Owner: J-b'C- Ki dd-p-r <br /> Address: 52 36 tC/_/ n 2 �4-GUnJ <br /> (2614&n V U�ClC11 C,yl b Phone: -76 3 <br /> Orieinal Parcel Information n <br /> -6�-� v ¢, p <br /> Parcel Identification#: - etian �0 Township �6N Range1V W <br /> 0 <br /> Original Description (or attach copy): <br /> o <br /> y Current Zoning: R R p Z FloodplaiT: Wetlands i'N: kc <br /> C�.IJ 3 f 2 � Zs <br /> m <br /> Lake/River Classification: Name of Water Body: //Le�1 <br /> e <br /> New Parcel Information <br /> 31 <br /> Proposed New Legal Description and Parcel Size: 5ft) <br /> V I V6 '/V <br /> L&-t qqO— 3. '4CJ <br /> /__&-L c// r3 , -/ /3 CJ Acres: lo. <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: /w,L'Ate Rrvwo/ <br /> Proposed access to public waters to be provided Y6 p <br /> w <br /> If yes,describe access: <br /> 1 <br /> ➢ Does parcel meet Zoning Requirements? Yes No rk <br /> N <br /> ➢ Does parcel require a Survey? Yes No A <br /> ➢ Permit application fees submitted. � Amount$ -��- Receipt# a <br /> n <br /> ti <br /> at <br /> Reconciles With Real Property Lister es No Date: <br /> CL. <br /> 7o If not, explain: <br /> o <br /> 'a <br /> N \ <br /> t <br /> Applicata . Approved / enied Reason for Denial: J Q <br /> Land Use: Date: <br /> 2/18/2003 ���� <br />