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Pre-application Consultation Form <br /> Request For Approval— Subdivision <br /> Burnett County Land Use/Zoning Department <br /> Burnett County Government Center; Siren, Wisconsin <br /> Applicant: <br /> (,()Owner• AUi'Aj <br /> pe, flax f9 12U25 LI'7TLe 7"ra_4& lFal <br /> Aiag:` 6'e&mi344�,� <br /> Phone: 715-X66 - 6� 5 Phone: 7 3 994 <br /> Original Parcel Information: <br /> ➢ Location of Property: 61. 3 <br /> ➢ Section: 91 Township: 3? Range: 8w Size: '� 5 <br /> ➢ Legal Description: HLl- OF Lo-tS /--?- <br /> allOF 5M y <br /> ➢ Current Zoning: g l FloodplaiWetland I'N.• <br /> Cl&u 1 Lk- <br /> New Parcel Information: <br /> ➢ Land Surveyor Preparing Plat/Map: <br /> Z 'Via+tiy 21'r r• S /h E <br /> ➢ Number of Lots: � Proposed Zoning: �� <br /> ➢ Regional Flood Elevation: " A417e L A <br /> ➢ Will Access to Navigable Body of Water be Provided/Available,9N: <br /> ➢ Type of Access (Example: Outlot, Easement, Etc): `it;t•✓&,a, y 7 <br /> ➢ Proposed Water and Sanitary System: ri✓ate e_ <br /> \/ > <br /> ➢ Proposed Use: Residential: X Commercial: Other: <br /> Date: Signature: <br /> For Office Use Only — Fees Collected: <br /> Date of Land Use Committee Preliminary Acceptance.-4 ° Action: <br /> Date of Land Use Committee Final Acceptance: Action: <br />