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tJ r f 1 L/"Zlcu( 1b;QU 111Cy4dZUbl L r'A(at U1 <br /> 15:51 17150C.G420C ulaUV� ING PAIZ a2 <br /> ON COMPUTER/SCANNEU <br /> Burnett County Subdivision Permit Applic atiorl FtH(fmst.cccmprn, flomt). <br /> sudivisiwt w/o 5msy: S10,00 <br /> and/or Pr®-Applicgtion Form suadi•1rio�W s,t:vts..xloe.�n.s;s.o�,�. <br /> Owyaw hndai ilhlld 242 Z6.�L GLfy1 CGPn cS/1'Gio, <br /> i E V j I J?" Aq J � a,�1,0- Phone: <br /> �Q� .ginal P n d I ation <br /> Parcel Idealffivotisa 01 d.' ,��71 Section_ _Township yQ RAnge 112 �jo <br /> tlal j)tgtri a(or attarti COPY): <br /> --- � t <br /> h' <br /> Ghrneai Zoallt$, Floodplaln Y,"+C: _.. � Wetlands'Y/N,. ..-,.L....---- <br /> Lalas/Wwr Nome of Water Body: <br /> It9wY'trr4* 109!itt a�don <br /> Prepeeed New xopol rhoscriptioa and Parcel Size: <br /> NJ <br /> Ar rvv: <br /> (lf parrec!b to be t+urvey4d�provide prelimftes. y m■p, 5.,,sttacl+ee rnr prellm(nan map re-quirements.) <br /> j Trvp d&tow to podia read: <br /> �Iwaten$(Ownr. — R <br /> Dora pore/Mawr Zouing Requirements? Yt s IVG o <br /> N JI <br /> p Dots pmel rvgWre a Swwy7 es Nn I <br /> ! ➢ Penrrk tspplieatiwe JGat tu6rntlrtrl7 C7 4r u>l>�r S.'�' Iiat erpt tf 160-5-/ - {! <br /> — � f <br /> M Rmenaw wkh Rsal Fnspom Ustor Yee Na Dato. Mt <br /> Appamtfas: Apptw%'eti DenNd Roston for D-11 alt— __-- ( ;Q <br /> Dare: •� G GY. 16, <br />