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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+$5.00/lot <br /> tn <br /> Owner: U &d 44!jxj� <br /> Address: r/5&1 ?i 56-th- ao k.J <br /> a �� lt2l i &.Jl* 5 1727 Phone: <br /> Original Parcel Information p �� <br /> 5 p3un/ g <br /> Parcel Identification#: Oy2-a56h-02-30USection Township Range z <br /> 0 <br /> Original Description (or attach copy): 5 E 1 tj 5 W VY Q AJJ NE Y H <br /> S vV I�H <br /> 0 <br /> y Current Zoning: U z0 Floodplain Y&_ Wetlands Y6.) <br /> �• Lake/River Classification: — Name of Water Body: <br /> d <br /> e <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> Acres. 6. <br /> (If parcel is to be surveyed,provide preliminary map. See attached for prelimina ,tap requirements.) <br /> Proposed access to public road: C, T <br /> (� <br /> Proposed access to public waters to be provided Y/N: <br /> If yes, describe access: APR Ail, <br /> '% <br /> ➢ Does parcel meet Zoning Requirement No <br /> � Ye �NINC�i <br /> N � <br /> ➢ Does parcel require a Survey? Yes l n <br /> ➢ Permit application fees submitted? Amount$ //5, U') Receipt# <br /> A <br /> Reconciles With Real Property Lister Yes No Date: p <br /> a <br /> If not,explain• I;u <br /> o � I <br /> y � W <br /> ApplicationApprove enied Reason for Denial: U1 <br /> Land Use: ! Date: o <br /> ci <br /> 2/18/2003 <br />