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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form Subdivision W,Survey: $200.00+$50.00/lot <br /> owner: Frank Charles Jr Buyer: b <br /> Address:7676 Grenadier Ave S R <br /> Address: <br /> Cottage Grove MN 55016 0 <br /> :tj, <br /> c <br /> Phone: Phone: `LP <br /> Original Parcel Information <br /> , <br /> Parcel 11)#: 07-032-2-41-16-35-2 01-000-012000 Section 35 Township 41N Range 16W '1 <br /> Original (orcopy):attach Descriptionco : W 330' NE-NW g <br /> ., <br /> P <br /> bCurrent Zoning: RR3 Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: 7V' <br /> • <br /> m Name of Water Body: N/A Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N:N Managed Forestry Law Y/N:N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM divide in 2 parcels <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C <br /> a <br /> K <br /> fD <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: <br /> .40 <br /> Signature of Owner:(1 _ C 7 .Q p Date: 3//4/c / <br /> Signature of Owner: 43 Yi Date: :6/1 p2 1 0 <br /> E.v <br /> Y Does parcel meet Zoning Requirements? Yes No dr—A " 60 3 5 L• m <br /> e. ➢ Does parcel require a Survey? Yes No <br /> d <br /> O <br /> °° <br /> > Permit application fees submitted? 0 Amount$ ©D #---- <br /> r Receipt# <br /> ___ <br /> r 0 Reconciles with Real Property Lister Yes No Date: ' <br /> °' If not,explain: <br /> ?O <br /> n <br /> o <br /> 0 <br /> .s <br /> 1::, <br /> Application: •pproved / Deni•d Reason for Denial: <br /> .y I -ester P • so <br /> fli �� ©tea i- -- <br /> Land Use: Date: <br />