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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/lot <br /> Owner: k(Ah lPip Ck r L7,4/y/{,! of, <br /> Address: q57 >C +2lI�OUti'r�G` 319 fr /lou. PC & <br /> & iud' � �'/Lm'5 A%hhe'yo`S SoPho e: <br /> 2 D NIS ka <br /> Original Parcel Information <br /> 0 3 <br /> Parcel Identification #: �*c 9.r/o-0/-404 gection ID Township 46 Range 16 <br /> f� z <br /> Original Description (or attach copy): <br /> O <br /> a Current Zoning: R2 Floodplain(9N: WetlandsON: <br /> n• Lake/River Classification: 2 Name of Water Body: Le V<- Lnkr <br /> d <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: csS h -g' V au <br /> Acres: C.D <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: F—A- /A p t1 ce-eJ.) A04 <br /> Proposed access to public waters to be provided&N: �.0'1� t7 <br /> . I V Ma <br /> If yes, describe access: <br /> WMAJ <br /> ➢ Does parcel meet Zoning Requirements? Yes No Z P COUNT1' <br /> S <br /> N OIdINc, <br /> ➢ Does parcel require a Survey? Yes No c <br /> ➢ Permit application fees submitted? Amount $ r1�5 V U Receipt # <br /> A <br /> xt <br /> Reconciles With Real Property Lister Yes No Date: a <br /> a <br /> � If not, explain: <br /> L0 <br /> a <br /> H k-0. <br /> QN <br /> Applicatiot . Approved / Denied Reason for Denial: i <br /> A <br /> Land Use: Date: <br /> 2/18/2003 <br />