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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> ,\5 and/or Pre-Application Form Subdivision w/o Survey 510.00 <br /> � a / Subdivision w/Sury <br /> r ey: szs.o0+ss.00no� <br /> Owner: <br /> J <br /> Address: Z Z' -5 <br /> Phone: —ILL-65 r— •7 r 2---7 <br /> Original Parcel information <br /> Parcel Identification #: L1 i8- j��_ 31G <br /> L' Section Township.f fA/ Range 9 <br /> Original Description (or attach copy): /F LV <br /> g p <br /> QJ <br /> 00 <br /> ov <br /> yy Current Zoning: �Z &N � Floodplain N� Wetlands 7 N <br /> m Lake/River Classification: Name of Water Body <br /> 0 <br /> 9h <br /> New parcel Information <br /> Proposed New Legal Description and Parcel Size: 0r <br /> p <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 /> L�i/ <br /> 7�7 �(�� <br /> Proposed access to public waters to be provided I CIN-' '% r <br /> If yes, describe access: <br /> i <br /> Does parcel meet Zoning Requirement . Yes j <br /> N NO IVE7T 04 <br /> Ai <br /> Does parcel require a Survey? IO/VING V N7Y <br /> Yes c <br /> o'o No <br /> A <br /> Permit application fees submitted? <br /> Amount S 1�_� Receipt# <br /> [- n <br /> CL Reconciles With Real Property Lister es <br /> No Date: <br /> o If not,explain: <br /> � oc <br /> a <br /> N <br /> /W <br /> w <br /> Application pprove enied Reason for Denial: 0 <br /> Ca <br /> Land Use: <br /> Date: <br /> 2/18/2003 U <br /> N.G <br />