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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 <br /> Subdivision w/Survey:$100.00+$I 5.00/jot <br /> Owner: /L 41-1,V <br /> Address: qL y-) e w L K <br /> 1rex-, ('J,s <L/ <br /> Phone: <br /> b <br /> Orieinal Parcel Information <br /> 3 <br /> Parcel Identification#: Section 33 Township 3 Range '. <br /> g ? o <br /> Original Description (or attach copy): C <br /> 0 <br /> f <br /> > Current Zoning: = Floodplain Y/N: Wetlands Y/N: AVA- <br /> M Lake/River Classification: Name of Water Body: <br /> m <br /> o � <br /> New Parcel Information <br /> o <br /> Proposed New Legal Description and Parcel Size: <br /> (n <br /> c <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: C <br /> m <br /> A <br /> If yes,describe access: .0 <br /> ➢ Does parcel meet Zoning Requirements? No <br /> C� <br /> N <br /> . ➢ Does parcel require a Survey? Yes No c <br /> 3 <br /> ➢ Permit application fees submitted? e <br /> Amount$ UR ° <br /> eceipt# e <br /> m ❑ Reconciles With Real Property Lister Yes No <br /> n. Date: <br /> g If not,explain: <br /> 0 <br /> a � <br /> (nJ <br /> Applic on: A r enied Reason for Denial: o <br /> O <br /> Land Use: �� S <br /> Date: G —G <br /> 2/18/2003 <br />