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01106/2005 09:04 3492166 B C ZONIIJG PAGE 01 <br /> Ffts Burnett County Subdivision Permit Application SUMMM W/o swM: $1�. <br /> �ba;�i�ago s,A.�y: slo.00 <br /> and/or Fre-Application Form SubdivisionwlSutvey:$'1(0.00+s(s.00nct <br /> Owner: �'M 3 )Uf' O 1 SO/�1 <br /> Address: BOY o2 kd•l <br /> kI,LC W SL! 8 5 3 Phone: <br /> _ -�zai5 <br /> gr <br /> kinal Parcel Information <br /> Parcel Identification#: Q 536 -o30&tion Township _Range p <br /> Original Description(or attach copy): i C. ga a �D <br /> 2 ._. <br /> d <br /> 6Y . <br /> Current Zaring: i!z oodplaiC' Wetlan YLake/RiverClassification: LV 3 Name of water Body: 4t.uva^Ac,4 &*&k Q <br /> � A- <br /> rt � <br /> Ncw Parcel Information <br /> Proposed New Legal Description and Parcel Size: s,&7 IYl,4,0 <br /> Acres: <br /> t reel is to be so provide preliminary ma See Attacked for preliminary map mesfs <br /> n Pa yed,P 1+ r7' p• Dr rY p <br /> Proposed access to public read: L_hT 6- d C{_eS S opj Com &0 a iod <br /> 5. Si I u tiv L,"Az izo kd , 4.o r (e q;e e e SS v of 00 /4t6 Ll w . <br /> Proposed access to public waters to be provided YN: _Lu_6 n <br /> v <br /> If yes,describe access:L—j an <br /> -- <br /> 0 <br /> D Does parcel meet Zoning Requirements? Yes No U1 <br /> D Does parcel require a Survey? Yes No <br /> K <br /> D Permit application fees submitted? O Amount S _ Receipt# <br /> Q Reconciles With Real Property Lister Yes No Date: <br /> If not,explain: <br /> � v <br /> _ w <br /> G <br /> Applicado : Approv Denied Reason for Denial: <br /> VJ <br /> o <br /> Land Use: - Date: a <br /> -- <br /> �JISJ2003 <br />