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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+$5.00/lot <br /> Owner: " 1�k6k&n zzc <br /> Address: -��1` ,/G / <br /> <� —(L�c Q, vV l All Phone: <br /> Ori final Parcel Information ro <br /> Parcel Identification #: .2-39—/ 3 Section Tovvnship 39/l/ Range Iyt'1/ 3 <br /> z <br /> G'. o f Scc 3 <br /> Original Description (or attach copy): Z. •• <br /> </ <br /> o <br /> Current Zonin <br /> y g: odplai Y WetlandY N: <br /> Lake/River Classification: Z Name of Water Body: <br /> 70J <br /> d <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: S C&"U 6 <br /> Proposed access to public waters to be provided l� p <br /> w <br /> If yes, describe access: <br /> ➢ Does parcel meet Zoning Requirements? Yes No c� <br /> N <br /> °o ➢ Does parcel require a Survey? Y No n <br /> ° o <br /> ➢ Permit application fees submitted? Amount$ .0D Receipt # S <br /> \ A <br /> r ?� <br /> ❑ Reconciles With Real Property Lister Yes No Date: C <br /> a C <br /> If not, explain: CI <br /> o Al 90 <br /> I <br /> Applicatio . ApprovedTnied Reason for Denial: 4j <br /> Q <br /> i <br /> Land Use: <br /> Date: 6? <br /> 2/18/2003 <br />