Laserfiche WebLink
Fees(roust accompany form): <br /> Burnett County Subdivision Permit Application Subdivision wio Survey $50.00 <br /> Survey of Rxisliog Parcel:$50.00010t <br /> and/or Pre-Application Form Subdivision el Stavo s-100.00 t$50.00,10[ <br /> Owner: t e-1%a- -e.z Buyer: jd& w-L cC� T AZ-ft,3 <br /> //�� A <br /> Address: 3s-C L✓ G<a v C k.i r e 5 f/J Address: 33�2 l L. /acv r r q L s. d <br /> �lCty., 5 �/O fa'' S /JUrNSV �It <br /> Phone: 7/tom-- �Sl- G &%S Phone- (tel--$37-3 Yi f <br /> Orii<inal Parcel Information <br /> ucic<•<. <br /> Parcel ID#:07-c),; c,-.x-yv"ide-•oy-3 a=te"`' Sectioa__,q' Townshi YP O•%U Range,4 L= <br /> 1 / 4 <br /> Original Description(or attach copy): N i-IJ S W =x .S (o(e � <br /> Y Current Zoning: �'1 / Floodplain Y/N.JL-\Yetlands YIN:-,4&—Lake/River Class:///// <br /> T <br /> R, Name of Water Bodv: Shorelsnd AgreementlSIPS YIN: <br /> c <br /> T Farmland Preservation YN: Al Managed Forestry Law Y/\: /1/ <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Gc1 /� /y`•U 5 C`-i 4 K $ (.,(o <br /> Acres- <br /> (If parcel is to be surveyed,provide preliminary map_ See attached for <br /> tf preliminary map requirements.) <br /> Proposed access to public road: j , c r ZZJ c r c(f<k,al !"c_ SS b <br /> Proposed access to public waters to be provided YIN- <br /> If yes,describe access: / f'"" � � � " � / <br /> Signature of Owner; }�1L Date: <br /> Signature of Owner: _ _Date: <br /> c <br /> 'v Does parte/meetLonim Requirements? Yes No m <br /> > Does parcel require a Survey:? Yes A"o tt <br /> 5 <br /> °q i Perrnll application fees submitted? Amount S �r 00 - Receipt is_ <br /> ❑Reconciles with Real Property Lister \\Yes No Date: <br /> L <br /> If not,explain:— <br /> Application: pproved ! enied Reason for Denial: <br /> Land Use:- Date: 3 ZOI <br />