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Sep 16 15 08 35a Larsen Auto Center 7153274791 p.2 <br /> 0911 SM S 09A4 Cortand CO ffAXMMMsa P.0021008 <br /> i <br /> • Pers Nnw et\anpen.f.n:j: I <br /> Burnett County Subdivision Permit Application mad..iGaaansy<<s: ,s.<f.ad <br /> flnd/orPre-App liestionForm *^eynfC..�n,hr�,:�wAPaa <br /> Gsaai.isinn../Swe-:53aa.sa-S.+O.OW a <br /> Xea5re1 <br /> •� <br /> Owner: Sa, &,'Il &&rear{ Dome inti//1�r7;[e fflF4l,By_s, �q <br /> ( Address:_I lk/3 �'C•, j Lek 2 Address: Yff,/ <br /> Fr�cla ic. <br /> Lox ,98'.37 14cafrer, eft ✓YYB3 � <br /> Phone: Ph nue: ?l�--37�•&OY� <br /> Orleioal Parcel la tortaanan <br /> Parcel 10 1:OF-QJY-.7-37. Srrtiw 27_ rarnshtLf. 9A)usM <br /> pp <br /> Ori`iaal Deseriptita(or atUth tapy)' I C_L i{fir_ A'i� F_X (,t,1 xav r t <br /> Carrent Ztn:ng:y/y�L�rletody4in YRe•�_Wnlawde WN; -I` LehdRir"er qtr;IB, _ <br /> n IVJaIe Of 1VJftr doily: Shart4nd A=r<cmcm/9►S YIN• �l <br /> Farmland Preservation Yh: Managed Forratry Le+YM: �- I <br /> Nc-Parcel Information 11 <br /> Proposed New upi Dexriptias and Parcel siw.. _(• .9 jYl n e• t O aAT dol rC SepP <br /> acres:_ <br /> (Irperrel Is to be serveyed,provide prrliminury map. See Nmrhed forprcll,Mnary nap rotuircmeaks.j <br /> Proposed aceeta to public rand: <br /> 0 <br /> r <br /> Pr•pulad aceta to pubDe,rater,to be pravlded VIN: _ <br /> If vea,dc3cribK acetas: Q <br /> SlganturcofOwner: <br /> I <br /> Signnlurr.of Owner: Date- <br /> a <br /> 'r Dntr parcel meal Irasirw Reaurrprrnfrt 1'a� No — - <br /> Does pared re4um a Sa"ty, lee rVu <br /> S 25 <br /> a i pestis appficarwu/rat sueaeruer/r O -+n,ru,u!' Rr<ti lel <br /> O Rgeoucda wen Real Property Lbto Ya No Date _ <br /> b <br /> a tf as4,sola ia. ..� <br /> n <br /> ApPMcHiaa: ppro<td s 'diad ataton for Denlar ---- .- <br /> Ls ad Use; <br /> I� <br /> f <br /> { <br /> 1 <br /> i <br /> y,go <br /> 33 <br />