Laserfiche WebLink
Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> pp Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision w/Survey: $200.00+$50.00/lot <br /> b <br /> et <br /> Owner: ,,/7vJ^ter a � rat 'J�etse� Buyer: !Z.v) a. 04,�fh i/� o✓e '<•t : <br /> :lisAddress: /y kJ'r!/ltV ^ `�e0 Address: cg E3ips- 4) '11 4a,''1 12") P <br /> cn <br /> 4,431";,, 4),r 6—Y8 ;e3 0 4 $r i.(). SYB 9 3 4y <br /> Phone: 7/,7 73 3 10,5-9 Phone: 7/3"-KS-44-,(0. 3 7 R) <br /> 9.s <br /> Original Parcel Information <br /> Parcel ID#: cia `'y Section 2 ei Township VO Range /1- <br /> Original Description(or attach copy): 4 'achi ei $a <br /> ,ncr <br /> Current Zoning: Floodplain YIN: iJ Wetlands Y/N: Y Lake/River Class: <br /> 3 Al- <br /> o Name of Water Body: Aa'el Ls la" Shoreland Agreement/SIPS Y/N: ill <br /> ri Farmland Preservation YIN: 12/ Managed Forestry Law YIN: /1/ <br /> F. <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: .4 f Ate_4 e / <br /> rl p <br /> Acres: ,5,-6 i Approx.. <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) d <br /> Proposed access to public road:1J.t d tit9 e" R o 4-d „t <br /> �Proposed access to public waters to be provided Y/N: Y <br /> If yes,describe access: J, r.o�T A-e c.1sS r4.� P r'i.:P e r T <br /> � r <br /> Signature of Owner: --(2r ✓- Date: p'1 e9 ,3 v I "49z <br /> Signature of Owner: t<--° -,--t l Date: 3/ /21 <br /> trs <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> Zb'9 <br /> W <br /> N > Does parcel require a Survey? Yes No0 <br /> 2 <br /> To ➢ Permit application fees submitted? ❑ Amount$ 3�0/ Receipt# 0�1 <br /> 0 Reconciles with Real Property Lister Yes No Date: .11 <br /> r <br /> = If not,explain: <br /> a. <br /> e <br /> o r <br /> a. Applicati pproved / enied Reason for Denial: _r <br /> y <br /> Land Use: Date: <br /> 9 / /0?/ <br />