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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:$100.00+$15.0011ot <br /> SOwner. C L � Co, <br /> Address: <br /> Phone: � � ��� a-74�0 <br /> Original Parcel Information 7 <br /> o3y-153a-03-yam <br /> Parcel Identification#: 01( - :3a- dQ-7MBectioa �o Township Z�Range�� z <br /> c' 'l P <br /> Original Description(or attach copy): N - c 4- 5W -Sf <br /> 90 <br /> Ser. T377�1 g )ec D <br /> O <br /> DO. Current Zoning: o FloodplaiT�L'; Wetland Y/ <br /> 9 � � <br /> e <br /> Lake/River Classification: Name of Water Body: <br /> a <br /> w <br /> New Parcel Information --7-6-6qc � <br /> _ /G (4 <br /> Proposed New Legal Description and Parcel Size: (SM ` 3 fUL� <br /> �s <br /> f parcel is to be surveyed, rovide preliminary attached for limina ms requirements.) <br /> (I PP P rY P• rY P <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: p <br /> If yes,describe access: <br /> ➢ Does parcel meet Zoning Requirements? Yes No � <br /> ➢ Does parcel require a Survey? Yes No A <br /> -e' 9 <br /> ➢ Permit application fees submitted? ❑ Amount S Receipt# <br /> w <br /> A <br /> e ❑ Reconciles With Real Property Lister Yes No Date: o <br /> a <br /> RIf not,explain: <br /> a MENw <br /> Applicatio Approv Denied Reason for Denial: 9j <br /> Land Use: _ � )f Date: <br /> 2/19/2003 <br />