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Burnett County Subdivision Permit Application Fees(must accompany forth): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: 9 D AleV Md AIS✓ <br /> Address: < �131 S. 4Z_d_ham c, <br /> 5 • ix Fad / <br /> ) wl Phone: <br /> ? <br /> Orieinal Parcel Information <br /> Parcel Identification #: .3Y-'15a96 <br /> ()Section dl— aSection X23 Township .37A/ Range <br /> z <br /> 0 <br /> Original Description (or attach copy): Lot I CSA Ve./• <br /> fA Yc t/ j n G,.,,o Z.f (0V <br /> O <br /> Current Zoning: Floodplah N: Wetlandq N: <br /> o h. , <br /> Lake/River Classification: .2, Name of Water Body: / /z <br /> m <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: 467 6ic C5/r) V1'9 *) <br /> ► oo- poi . ,v G. L . C1rA' <br /> csrn P'p_b� Acres: 0?,a. . y io <br /> (If parcel is to be surveyed, provide preliminary map. Seeattachedfor preliminary map requirements.) <br /> Proposed access to public road: A.w^ <br /> Proposed access to public waters to belprovide Y/N 7' <br /> If yes, describe access: IVohc "F6.4' ZV IIC�. eI <br /> ➢ Does parcel meet Zoning Requirements. L Yes No <br /> • ➢ Does parcel require a Survey? No % J <br /> n <br /> ➢ Permit a lication ees submitted? Amount $�S ��= <br /> P Receipt # <br /> • � A <br /> r ?� <br /> Reconciles With Real Property Lister Yes No Date.._ C <br /> If not, explain: �CL �n'1A i , QN7'' <br /> z 4;Z� <br /> a <br /> Applicatio Approved enied Reason for Denial: <br /> Land Use: Date: /9 <br /> 2/18/2003 (�l <br />