Laserfiche WebLink
Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/1ot <br /> and/or Pre-Application Form Subdivision w/Survev: $200.00+$50.00/lot <br /> Owner: /�IEDCyf/f! /�A°1/aY /?�S' Buyer: & ,V.yEThf "A *A,4±Z <br /> Address: /�i Gr/EST `� G�O.t6� ✓E Address: n� SAX <br /> z <br /> '= <,•,t�rs,o�R�, /a//.�� fry© �"�s�#�_ k// 511'✓ <br /> Phone: 7/� 3 J 3 G S Phone: <br /> y <br /> Orieinal Parcel Information <br /> !G <br /> Parcel ID#: 07- 12Y67 -Y f /9-o?7- 3 03- Section eZy Township 394/Range /`J l✓ <br /> 000-0//000 <br /> Original Description(or attach copy): / - <br /> T/� �•1 fT G�►G FG`E T Art�py7"ZZ /Vo"fr/ �70 FEE? dF TiYE G/ES T <br /> yOFG`c`T 4F TiYE .SL✓�f. SLd� .SHIT/�slyy X17 T /"'/ '/� /�LG! <br /> Current Zoning: K 3 Floodplain YIN: /t�0 Wetlands Y/N:�Lake/River Class: AlIx <br /> Name of Water Body: Shoreland Agreement/SIPS Y/N: A/U <br /> '. Farmland Preservation Y/N: A/40 -Managed Forestry Law Y/N: 41a <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: TE L�ilST e7a FffT,},{/,Q z/-/40 <br /> r , <br /> �. 77 3?/t/- .'f• 4/ Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: X57 <br /> m <br /> Proposed access to public waters to be provided Y/N: All� <br /> If yes,describe access: <br /> Signature of Owner: Date: <br /> Signature of Owner: Date: o <br /> a <br /> ➢ Does parcel meet Zoning Requirements? Yes No � <br /> xc <br /> °a ➢ Does parcel require a Survey? Yes No <br /> Q°o tt <br /> ➢ Permit application fees submitted? � Amount$ �.J�r�� Receipt� <br /> �. econciles with Real Property Liste Yes No Date: <br /> m <br /> 0 <br /> If not,explain: <br /> A <br /> n <br /> 0 <br /> -s <br /> a <br /> N <br /> Applica ' Approved enied Reason for Denial: <br /> Land Use: Date: <br />