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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: $10.00 <br /> and//�o�r Pre-Application Form Subdivision w/Survey:$100.00+S15.00not <br /> Owner: l t L1-le,�j lVQi/ l�-m <br /> Address: 'q�//�/ �%,� OLd //� �7 / �/ <br /> VV1-l�l �/�, ��1 / �Z5 Phone: /1r�1V _5H17 <br /> A <br /> Ori¢inal Parcel Information <br /> Parcel Identification#: QM— y 3 ZQ—61366Section Z6 Township�Range 14111 <br /> o <br /> Original Description(or attach copy): Al 6ti �/y N� 2q � <br /> O <br /> Current Zoning: _R13 Floodplain ye Wetlands Y6. <br /> �• Lake/River Classification: Name of Water Body: <br /> m <br /> o <br /> New Parcel Information <br /> Czzl <br /> Proposed New Legal Description and Parcel Size: <br /> m <br /> 5 <br /> Acres: /C�, 26 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: j-�� <br /> d <br /> Proposed access to public waters to be provided <br /> If yes,describe access: C� <br /> i <br /> ➢ Does parcel meet Zoning Requirements? es No 5 JJoYt T "/o 5,007-. <br /> N c <br /> °o ➢ Does parcel require a Survey? Yes No <br /> o v <br /> � e <br /> ➢ Permit application fees submitted? ❑ Amount$ Receipt# <br /> x <br /> r <br /> o ❑ Reconciles With Real Property Lister Yes No Date: <br /> a <br /> If not,explain: <br /> 0 <br /> -- 1 <br /> Ci <br /> Application: Approved / Denied Reason Denial: <br /> O <br /> Land Use: Date: 27ua 05 <br /> 2/18/2003 <br />