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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form Subdivision w/o Survey: $10.00 <br /> hp Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: PQL I- / <br /> Address: 4//3 t0 5/hQ/I'1 <br /> �• , �Ul ay�3c Phone: <br /> Original Parcel Information b <br /> 37--5226-a/ <br /> Parcel Identification #: y� // 1� _ / 3 <br /> Section �Ip Township�Range 1�l5 W =� <br /> Original Description (or attach copy): <br /> AJ <br /> Z) <br /> Current Zoning: R 2 Floodplain Y6 Wetlands Y(0 <br /> v � <br /> m <br /> Lake/River Classification: Name of Water Body: <br /> y <br /> New Parcel Information S�l <br /> Proposed New Legal Description and Parcel Size: t� /n — 1 7 1 <br /> _CS mV. 9a Paio-ail <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: -L_&"yWM4"n- gledyz-y <br /> Proposed access to public waters to be provided C <br /> d <br /> If yes, describe access: <br /> ➢ Doer par-eel meel Zoning Requirements? )es No p <br /> N Q _� <br /> � ➢ Doer parcel require a Survey? Yes No n <br /> o' <br /> ➢ Permit application fees submitted? A»tourtt $ SIReceipt # <br /> r � <br /> ❑ Reconciles With Real Property Lister Yes No Date: O o <br /> a W W <br /> If not, explain: <br /> t <br /> 0 1vn` <br /> y. V <br /> � R1 <br /> t <br /> Application: Approved Denied Reason for Denial: ti��c dYee.. -�a/Z_ O 0 <br /> — - D /v <br /> Land Use: 1I/ <br /> Date: <br /> 2/18/2003 (� <br /> W / <br />