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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: $25.00+$5.00/iot <br /> Owner: <br /> Address: <br /> Phone: 7/5 <br /> Original Parcel Information A <br /> as -/oo <br /> Parcel Identification#: `I 7 'Q�9�ectio �� TownshipVD Range B <br /> Z <br /> v �° <br /> Original Description (or attach copy): Cs/-n 3- <br /> (1, <br /> L0-L a Cm V tolScJ <br /> o <br /> Current Zoning: {�� ";l Floodplain Y/N: /U Wetlands Y/N: <br /> '— Lake/River Classification: Name of Water Body: <br /> m <br /> e <br /> w <br /> New Parcel Information p / <br /> Proposed New Legal Description and Parcel Size: CS/n U <br /> Acres: /---� <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C� /1Ci ems/ led <br /> Proposed access to public waters to be provided <br /> A <br /> If yes,describe access: <br /> I <br /> ➢ Does parcel meet Zoning Requirements? es No <br /> N <br /> °o ➢ Does parcel require a Survey? es No / ' o <br /> ➢ Permit application fees submitted? Amount$I] Receipt# L 1 S8 e <br /> x <br /> M Reconciles With Real Property Lister Yes No Date: Oo <br /> � O <br /> If not,explain: r <br /> o � Q <br /> H .V <br /> W � <br /> Application: pproved / Denied Reason for Denial: W <br /> I <br /> o � <br /> Land Use: �a Date: a—a 63 <br /> 2/18/2003 C <br />