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Burnett County Subdivision Permit Application Fes(must accompany form): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision wl Survey: $25.00+$5.00Aot <br /> Owner: [)0061-PRS NA 10 LV-IE- <br /> Address: 13552 GoSSAML=R 1JX� <br /> APPLE VALLEY M 0 S51 -L - Phone: ' <br /> Original Parcel Information A <br /> 3 <br /> Parcel Identification#: 12 42o-7 (D+SocSection-7Township 46 Range t_ z <br /> 0 <br /> Original Description (or attach copy): Lo i 3 e S rn Vo L. CP p 34- Et 35 Gj <br /> 6' <br /> O <br /> y Current Zoning: Floodplain YIN: t Wetlands Y/N: _ <br /> Lake/River Classification: Z Name of Water Body: N AN1 >_IL b <br /> r <br /> e <br /> New Parcel Information $ <br /> Proposed New Legal Description and Parcel Size: Wo C N n.o G r S Tb L o 7- <br /> Tf}I S 1 S Rn1 L=Y.1 S T"I nl G PR,Q�C,E L <br /> Acres• <br /> (If parcel Is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) 7� <br /> Proposed access to public road: M AIL h <br /> Proposed access to public waters to be provided Y/N: N t� v <br /> A <br /> If yes,describe access: o <br /> ➢ Does parcel meet Zoning Requirements. *esNo <br /> ➢ Does parcel require a Survey? No e <br /> e <br /> ➢ Permit application fees submitted? Amount$ `D O`( O Receipt# a C ° <br /> e <br /> n <br /> a <br /> ❑ Reconciles With Real Property Lister Yes No Date: O <br /> a SU <br /> If not,explain: <br /> 0 <br /> a O <br /> w J <br /> O <br /> Application Approved Denied Reason for Denial: <br /> y 8 <br /> Land Use: Date: <br /> 2/18/2003 <br />