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Fees (must. accompany four-,): <br />Burnett Count), Subdivision Permit Application 5ubdivisianvvloSurvey: 550.00 <br />Survey of Existing Parcel: $50.001lot <br />andlor Pre -Application Form Subdivision wtSurvev: $200.00+S50.o0tlut <br />bcLv, 1-1 <br />Owner. 33ent,e tole Rena. !rccg+ -R,AW d `- (r'tVPYs�rS�ar, <br />Address:,ffnfq /% n1—_NIeA iii' Address: d` &PQ Ma�jetn t <br />Picone: <br />Oridnal Parcel Information <br />07 03.',2-yf-0s=�?v-Gy3�c�X? <br />Parcel ID #: Section JT .Townsbip z1/. Range <br />Original Description (or attack copy)�t 4-0cs.. La. <br />t',4 ( (_ai, L) / P \ct l-ev>!>f 1, <br />Current Zoning-,�T R;�Floodptain Ye` ,, ___�Nvettands YIN Lek iver Class: <br />Name of Water Body., th, n r v 0r. l._- e Shoraland A; reement/S1PS <br />Ncvv Parcel information <br />Proposed New Lcgai Description and Parte! Size: fl 2 W r 164 - <br />Acres: 64 -Acres• <br />(It parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: <br />Proposed access to public waters in be prov=ided Y/Ni . <br />Amount $ IL_� Receipt 9 _ <br />SURNErr COUNTY <br />ZONING <br />