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/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision w/Survey: $200.00+$50.00/lot <br /> 5c '"I'LAG <br /> Owner: fle6 tiiYe rat flit 1(/ Zb ya, Buyer: g, <br /> Address: / h/1/2-.5‘ <br /> f /V - it-(4 ?rpt d Address: F0.4►I 1l/ d�tk i c{ 6-/1 t4'e o <br /> ,U u d,,„ M x i ql 07 c4 <br /> Phone: 219. ),/o ^ °616 Phone: <br /> t <br /> Original Parcel Information 0/5.000 <br /> ✓� OS- 0 S� <br /> Parcel ID#: 0.7- 03? a -Li/-1.5--2.6`,5 Section 024S- Township / Range 15 <br /> Original Description(or attach copy): A .2d <br /> Re Z <br /> /C <br /> Current Zoning: e 2 Floodplain Y/N: Wetlands YIN: /v v Lake/River Class: <br /> a Name of Water Body: ( 61 L- re. Shoreland Agreement/SIPS Y/N: <br /> iz <br /> n' Farmland Preservation Y/N: V Managed Forestry Law YIN: , <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Se,e a. ch e d p <br /> It <br /> p <br /> Acres: �` T °�G�es T� <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) C7 <br /> J L m <br /> Proposed access to public road: g y 0 3 t (ilea e eufc ni t o l. <br /> Proposed access to public waters to be provided YIN: YE s <br /> If yes, describe access: Co?1fIt p -- rt-pGtrr c v <br /> lSignature of Owner. Date: �// / Z <br /> Signature of Owner: Date: <br /> `)= Does parcel meet Zoning Requirements? Yes No eh- 2 6 / Z ic <br /> 40 2.693 -030 yb R°0 <br /> c Y Does parcel require a Survey? Yes No <br /> Permit application fees submitted? ❑ Amount$ 2.5v z ' Receipt# <br /> Itl <br /> IR Reconciles with Real Property Lister ED No Date: (13/act/at <br /> t" <br /> P If not,explain: <br /> a <br /> O <br /> Q' Applicat' : Approved / enied Reason for Denial: <br /> Land Use: e. am U� perm I V- Gu r-21- 1 a 3 Date- <br /> e— <br />