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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: $10.00 <br /> pand/or Pre-Application Form Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: M (j"l" /tC <br /> Address: o?Sj-/3 /�,6,(�QZy eia �j a h lei, p <br /> 1 �� � S 7/ Phone: Y d— <br /> Original Parcel Information 00 <br /> o0�J : � ; <br /> Parcel Identification #: -0�Section ' b Township 3 � Range Iq3 <br /> z <br /> Original Description (or attach copy): _ 41c) c-2J1R-� ,S.0 At Ui <br /> Ob <br /> A <br /> O <br /> o Current Zoning: A- Floodplain� Wetlands <br /> Lake/River Classification: Name of Water Body: , <br /> m <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Q h <br /> 'i-e SE /VW 16- 3S-)y <br /> be Nty"ed uJi'*h Ng NW ) Acres: <br /> o u:,A5 N tla N<,C N W n o W buy,»y 5`/a N 6 Ahj) ZT StAis to a.xAt4. <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: a-C'�,4� Y-hJ rLu c,4 /V IV(4.� <br /> Proposed access to public waters to be provided Y/N: t" Li <br /> p <br /> If yes, describe access: <br /> 9.l <br /> t <br /> ➢ Does parcel meet Zoning Requirements? Yes No d <br /> N <br /> ➢ Does parcel require a Survey? Yes n <br /> o <br /> 00 3 <br /> ➢ Permit application fees submitted? I Amount$ Receipt# r <br /> K <br /> A <br /> C• � u <br /> ❑ Reconciles With Real Property Listed Yes No Date: iak p <br /> � O <br /> �� qc <br /> A If not,explain: <br /> Application: pp ved enied Reason for Denial: I <br /> La Use• Date: <br /> 2/18/2003 ! h i <br />