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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+$5.00/lot <br /> Owner: �EG Ja4hSoh l �V�hJuh 7fr r, <br /> r s�, <br /> Address: nn .31423 N �R <br /> tAvole <br /> .//Q/yfoll y wfs Phone: 6So(—7q7f <br /> 321900 OrieinalParcel Information <br /> Parcel Identification #: 6 p 63 ov 3 <br /> p f . <br /> 4 Section jTownship Range <br /> �+ z <br /> Original Description (or attach copy): .&-i Q I God Z-6i A16 At W <br /> enol SE N k, o <br /> 0 <br /> > Current Zoning: 2 Floodplain YIN: wellandtoqN: <br /> A <br /> Lake/River Classification: — Name of water Body: — LI <br /> m g1 <br /> s <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: L ouh f y ��pp �/S'14 6 Z•S/te - <br /> S <br /> Acres: <br /> (If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: S A.WA <br /> Proposed access to public waters to be provided Y (V o <br /> m <br /> A <br /> If yes, describe access: N <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N <br /> ➢ Does parcel require a Survey? )es No n <br /> ➢ Permit application fees submitted? Amount $ .3/0. M Receipt # <br /> A W <br /> a g� <br /> ❑ Reconciles With Real Property Lister Yes No Date: p <br /> S1 J <br /> If not, explain: , <br /> o CrI , <br /> y <br /> W <br /> O <br /> Applicatio Approve / Denied Reason for Denial: 8 8 <br /> �7 // r <br /> Land Use: L ( ?3YY)YYII P Date: <br /> 2/18/2003 <br /> U <br />