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6/U tC <br /> Burnett County Subdivision Permit Application Fees(must accompany form): I C, <br /> Subdivision w/o Survey: $10.00 { u, <br /> and/or Pre-Application Form Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: to V <br /> n <br /> Address: 2 o.301 <br /> Crags ural, b) Phone: 01 4 91 <br /> Original Parcel Information <br /> 3 <br /> Parcel Identification#: o 3 4- IS` ;a -o I Q( Section _Township -3Range <br /> Original Description (or attach copy): <br /> O <br /> a Current Zoning: _� Floodplain Y,@ Wetlands Y�jT <br /> v � <br /> Lake/River n Classification: Name of Water Body: (� <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: s t f 0� S '14- <br /> Acres: <br /> 1 Acres: a <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: v <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: '✓ ((�11 <br /> v� <br /> ➢ Does parcel meet Zoning Requirements? Yes No SURA yF <br /> °e ➢ Does parcel require a Survey? Yes No Z0�NGV N7 ' o <br /> vo 3 <br /> ➢ Permit application fees submitted? ❑ Amount$ Receipt# <br /> A <br /> a . <br /> ❑ Reconciles With Real Property List Yes No Date: <br /> a <br /> If not,explain: <br /> 0 <br /> C <br /> CL <br /> Vl <br /> Application: Approved / Denied Reason for Denial: <br /> Land Use: Date: <br /> 2/18/2003 <br />