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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: -W'e S /.._ rrC7�P f' f 1' 2 cJ& <br /> Address: g5z S 7 <br /> SIp p o i-t P r, 4/r S <eVAV/ Phone: 65 <br /> Original Parcel Information n <br /> t3Z►°7o! Soo 3 <br /> Parcel Identification#: a zi a-t a( 9 o o Section- -7 _Township 3 6 Range z <br /> 0 <br /> Original Description (or attach copy): b(ai5-r -rMAc r 1 a N qac.. RA t. )- d <br /> nJ W <br /> 't4- S l'(:�, 7 13 t n] lz-1 4- W 6� <br /> y Current Zoning: IZrz."5 Floodplain Y/N: rJ a Wetlands Y/N: Ycs�— 41 <br /> re <br /> Lake/River Classification: r�/P�— Name of Water Body: N1�- <br /> m ` <br /> R <br /> New Parcel Information I <br /> Proposed New Legal Description and Parcel Size: q LaT-" C 5 M 5y St„t� S a/.1 c <br /> S /arc 2>✓r �o T"S C� /'Yl (/ a D ��i> �l <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: kJ It,t-I f�rA5 P � <br /> Proposed access to public waters to be provided Y/N: tJ 6 d <br /> If yes,describe access: til Z,4,- <br /> > <br /> /}--➢ Does parcel meet Zoning Requireme Yes No 0 <br /> N c <br /> ➢ Does parcel require a Survey? Yes c <br /> J 3 <br /> ➢ Permit application fees submitted? Amount S L�S. U Receipt# Sia/ °e <br /> w <br /> A <br /> 1 <br /> r ?� <br /> 0 Reconciles With Real Property Li ter Yes No Date: <br /> a <br /> If not,explain: � c pa <br /> Application Denied Reason for Denial: <br /> Land Use: Date: <br /> 2/18/2003 S <br />