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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: S10.00 <br /> and/or Pre-Application Form Subdivision w/Survey:$100.00+S15.00not <br /> T m <br /> Owner: 1 Imo-Lhl/ ' ' `0.nnth <br /> Address: l S� S K o a 00 <br /> Gly r�sb Phone: 9a <br /> Orieinal Parcel Information n <br /> a <br /> Parcel Identification#: 040-3633-0L}0005eetion 33 Township 33 Range <br /> 0 <br /> Original Description(or attach copy): Th e S E (/J, 0 F fl,, <br /> e, w <br /> 0 <br /> Se- 116t oV +he sW i/4, SecJjon 33 <br /> 0 <br /> -r W C)V rn rs <br /> o <br /> Curreat Zoning: t ki Floodplain Y/N: Wetlands Y/N: N A <br /> 9 <br /> Lake/River Classification: N Name of Water Body: <br /> Q <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: C(2,r t' F i e <br /> Sk,.rVe-N rnq b co"Tto"% 0t a <br /> O F , © AC_r Pl-_c e 0.C- Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) p <br /> Proposed access to public road: 0. G,-,,6s R c + �e r q13c . <br /> Proposed access to public waters to be provided Y/N: m <br /> A <br /> If yes,describe access: <br /> ➢ Does parcel meet Zoning Requiremen s? Yes No Q <br /> ➢ Does parcel require a Surrey? Yes No e <br /> Vail a <br /> ➢ Permit application fees submitted? O Amount S Receipt# <br /> A <br /> e ❑ Reconciles With Real Property Lister Yes No Date: p <br /> a � <br /> RIf not,explain: 9 <br /> a <br /> W <br /> W <br /> Applicata Approv / Denied Reason for Denial: <br /> 0 <br /> 0 <br /> LI <br /> Land Use: Date: �/ S <br /> �nsnnn: <br />