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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+$15.00n« <br /> Owner. TODD A0j>379UJ TWSONAt_ REf FoIZ i4O2'r'ANS 4ZH*1Sa4 �1ri <br /> Address: R a, Pa-A .So 7 <br /> 6.2ANTS$UILFs k/r- SAF 84 y Phone: 463 S36S <br /> Original Parcel Information <br /> 4z 20534- o7 7oo <br /> Parcel Identification#: 4: 2S 34 o-r 900 Section_3 4-- Township 3 8 Range_ I ��re```��, <br /> Original Description(or attach copy): ATrocgat> <br /> rzrtl oNc- <br /> Current Zoning:AZ E. c'F M Floodplain Y/N: Wetlands Y/N: 5om0 <br /> V <br /> Lake/River Classification: I Name of Water Body: 1 J ooy LAKE <br /> r <br /> 0 <br /> w p <br /> New Parcel Information s <br /> Proposed New Legal Description and Parcel Size: _ o N G ¢ PM2C BL CS M o <br /> 3 <br /> _ ONc # J �AfzCG—c, CSM <br /> Acres: 7 S h t <br /> (if parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C'rlt M A:Nu CASL-ma r <br /> Proposed access to public waters to be provided Y/N: _ Y1= r S _ � <br /> If yes,describe access: 3 LAKC SHIM20 PARCUEtSUEtS <br /> CX) <br /> USE <br /> P <br /> ➢ Does parcel meet Zoning Requirements? QeJS No (n <br /> ➢ Does parcel require a Survey? Yes No g <br /> Permit application fees submitted? 13 Amount S Receipt# <br /> 1i <br /> x <br /> ❑ Reconciles With Real Property Lister Yes No Date: W <br /> C6 <br /> If not,explain: �W <br /> a -� <br /> Js <br /> 6 p <br /> Application: pproved / Denied Reason for Denial: a a <br /> Land Use: Date: <br /> 2/18/2003 <br />