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Burnett County Subdivision Permit Application Fees (must accompany form): <br />Subdivision w/o Survey: $10.00 <br />b and/or Pre -Application Form Subdivision w/ Survey: $25.00 + $5.00/lot <br />Owner: J02 Ga. /Q m b o s <br />Address: % 7 9 eD 11/d E ON COMPUTERISCANNED <br />S,DOONPf l�tJ ! �y0 �� Phone: <br />—T <br />Original Parcel Information �/,,/ <br />a �/t'V <br />Parcel Identification #: �� ��-ly Zy a OJ�9� ction Z�% y4V Range g <br />z <br />0 <br />Original Description (or attach copy): a&r t 0 r e5m V/ ,0 <br />G'.�. y <br />0 <br />Current Zoning: u food ain Y& Wetlands YC <br />��—• Lake/River Classification: Name of Water Body: <br />New Parcel Information <br />Proposed New Legal Description and Parcel Size: zl. /l% <br />Acres: '93 <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: Of l <br />Proposed access to public waters to be provided Y� ! J <br />If yes, describe access. Fn I <br />.W4 U <br />➢ Does parcel meet Zoning Requirements? YesNo pNE 1 <br />N BUR'�- <br />T COU <br />NTM <br />E. ➢ Does parcel require a Survey? Yes No ZONING <br />TQ <br />➢ Permit application fees submitted? �] Amount $ 115_4-0 Receipt # <br />v <br />[.� Reconciles With Real Property Lister Yes No Date: <br />(� If not, explain: 1 <br />Applicati: A proved Det d -_ -)Reason for Denial: Q 14 --lel <br />PI;e' l '' se e u� <br />Land Use: Date: <br />2/18/2003 <br />