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RECEIVED 09/10/2010 16:36 6514553869 KREMER SERVICES <br /> 01/17/1994 13:13 17158664206 WAGNER SURVEYING �/ PAGE 03 <br /> L-Sbdivisiun <br /> must accompany Corm): <br /> uirnett County Subdivision Permit Applicationision w/o Survey: $50,00 <br /> and/or Prey-ApplicationTorm Existing Parcel: 0,00 /Iot <br /> w/Survcv 5200.00+$SO.Q4/lot <br /> o*w& VVAs y <br /> �?..0 Z L <br /> Adc a t TrL �7ZA F l o es <br /> Phone: ^W'3'7 � <br /> ,l ti <br /> "j7//-Oc)zOO Original Parcel Information <br /> �—ZZ + 66 Inc Section �! To �Range <br /> oiDime e <br /> ription er ttttae6capyJ 52 <br /> 5 v�l :-5 VV SEA I <br /> C oat xosln�: T Fioodplain Y& Wetland6N: _ <br /> ILANOrstw eatlpi�: y� Name of Water$ody: �- <br /> 3 d AAg eemt or VC _Farmland Preservation Y Managed Forestry Law Y � <br /> New areel Wormadon <br /> (n <br /> Pr4wed Nev Lgal n and Parcel Size: C / 9" 7 4 <br /> F Acres: <br /> (ifi4reel ia:4o be sary , Ylde preliminary map. See attached for preliminary map requirements.) <br /> aeeese to o l,,I <br /> P v V ! 111e /Z!U 4- � r r t� <br /> rtpMed aftm to pub to be provided <br /> out Ca0. <br /> Sl Ik toalxo�aer: `7—L� —ZG Date: r� <br /> Date: <br /> 3 <br /> > Does parcel meet ZOR frements? Yes No 6 )✓ TLbze`' <br /> a a•�ay-ic� � <br /> a Aire d ? yes NO <br /> o c � <br /> ft II van j tted? 0 Amount S 40 ,Receipt# <br /> r13 ` v1 <br /> Coneilde with Read Lister Yes No Date: 01 <br /> y� <br /> C \ <br /> a ( _ 40 <br /> yOy <br /> s d \/ 0 <br /> Ap at{one Approved Iteamn for Denial: <br /> 1 i <br /> Date: <br /> i <br />