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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: $25.00+55.00/lot <br /> Owner: C , kar ((� 0_6l�J 50Pte' <br /> Address: }f I G H ti./µ" V <br /> 6R-p�NrS3v12G. I jl o 9"4-0 Phone: 6 o?J -' CJ <br /> Original Parcel Information A <br /> 3¢/So5'o z¢o0 3 <br /> Parcel Identification#: o'L goo Sectio ip ) Range ^* <br /> Original Description (or attach copy): N. t►v n/Gs SE /✓W JE <br /> Sl/z- ate, Sfc 5 — 37— (8 <br /> �N cS L�Gtr 0 <br /> Current Zoning: A—2L, Floodplain I /N: Wetland Y <br /> V '. <br /> Lake/River Classification: A— Name of Water Body: /y/A_ <br /> m <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: v &CM-'s <br /> � <br /> J (e 1-0TS L/A) V`l <br /> fiA/ NE ScG, 10/W SE, S'/i SE SaC S-37-/gcres: A Giz; <br /> (If parcel is to be surveyed,provide preliminary map. <br /> (See <br /> �attached for preliminary map requirements.) <br /> Proposed access to public road: PrlUcit yc{y 3 <br /> e provided <br /> Proposed access to public waters to bd <br /> If yes, describe access: N q- <br /> � <br /> b <br /> t <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N <br /> ti ➢ Does parcel require a Survey? Yes No <br /> �. CJS �U <br /> ➢ Permit application fees submitted? Amount$ Receipt # °tee <br /> a <br /> Reconciles With Real Property ListerYes No Date: <br /> a <br /> If not, explain: l <br /> a <br /> fA <br /> jl <br /> Application Approved /^ nied Reason for Denial: Q <br /> �_- 51.1 <br /> Land Use: Date: <br /> 2/18/2003 O\ <br /> d <br />