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Fuss(mast accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Gxislinl,Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form Sublivisiin,w/Survey: $200.00+ $50.0(Nlot <br /> A <br /> Owner: C/•ktSf Y t-J. ,.y/ J Buyer: 5 <br /> Address: 511413 C. 41L,'4 Dag, 40 A f l/i" Address: <br /> C40441, 1-.1 I 53i/0 c <br /> Phone: 7-6-2 V.}5(r'i M 12trRVr t til Phone: +c <br /> Original Parcel Information W <br /> C,..i-(AZ-L- -L7.4,-eAcce <br /> Parcel ID 0: 0:; 042'2-3 •it; 34- 5 17-174 ,C2hurcsSection 7)/ Township 3 Range ie <br /> C <br /> Original Description(or attach copy): 1,-014 14- 17 cc= ffike cr. t. perA rr5 <br /> Current Zoning: RIZ-1 Floodplain YIN: V Wetlands YIN: N Lake/River Class: <br /> Name of Water Body: Woof? l-A G Shoreland Agreement/SIPS YIN: t t <br /> Farmland Preservation YIN: N Managed Forestry Law Y/N: <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: kit-LW I -r L}Ni Cr2Mt'tnitwiC i r;ir4 144, i'5 <br /> Acres: e9,4'h <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> io <br /> Proposed access to public road: tt4..i7.'t•i`t Pet.+ir ize,As> <br /> Proposed access to public waters to be provided V/N: /.4 <br /> If yes,describe access: <br /> Signature of(honer; / ''` Date: 2/20/21 z <br /> Signature of Owner: Date: <br /> r DoctDoesparcelparcelmeet Zoning Requirements? i'r-s N /&0c— <br /> Does <br /> Aro <br /> c i Does parer/require a Survey? Yes No a <br /> p0 <br /> w Y Permit application fees.sulatril el? 0 ,rmotrni$ <br /> 50, °°- <br /> 11 <br /> .40 <br /> Reconciles with Real Property Lister Q No Date: 062./p"Z4/aDal �l <br /> If not,explain: <br /> a <br /> i7 <br /> ro <br /> n <br /> ti <br /> a Applicatio . Approved / cnied Reason for Denial: <br /> Laxd Use: Date: <br /> 1-1//AeZi <br /> 14/ <br />