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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form Subdivision woo Survey: $10.00 <br /> pP Subdivision w/Sutvey:$I00.00+S l5.00not <br /> Owner: //��Go u lo- L,/,( PI a <br /> Address: l�li tJn q_d U // <br /> I <br /> Phone: 7104( - ICO <br /> v <br /> FOriginal <br /> Orieinal Parcel Informationcation#: 626-9101 - a7-�j0Section 2U Tonwnship 7Q/V Rangeiption(or attach copy): L6 T 15—16 0 r �C� G <br /> Q <br /> LA JltL�L VAPIY <br /> 0 <br /> 0 <br /> 9 Current Zoning: - 1 Floodplain YF-.) Wetlands Y V/�. <br /> g, Lake/River Classification: <br /> m Name of Water Body: <br /> o <br /> w <br /> Z <br /> New Parcel Information <br /> t <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: _C 7. {f. U vJ--) <br /> v <br /> Proposed access to public waters to be provided <br /> If yes,describe access: 6 i <br /> Does parcel meet Zoning Requirements _fYes No 0 <br /> ➢ Does parcel require a Survey? Yes No g <br /> 0 <br /> ➢ Permit application fees submitted? IJ Amount S Receipt# <br /> u <br /> r o a <br /> ❑ Reconciles With Real Property Lister Yes No Date: Q <br /> a <br /> If not,explain: <br /> o �0 <br /> v � <br /> Applicati Approved Denied Reason for Denial: <br /> a c <br /> Land Use: Date: <br /> 2/18/2003 <br />