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Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: S50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survev: 5200.00 s50.00not <br /> Owner: 51PDj1Eh S. SCo�r Buyer: ro <br /> `` �, <br /> Address: 17 922 Co n l; M P Aa f Address: <br /> IN' 9JK �',�Pid r,�r s3oys ° <br /> Phone: a(ca�- S��'7-3 a 9 7 Phone: <br /> Original Parcel Information <br /> Parcel ID#: 67-oil o7-10-/:,r-) 1 -S Section ,Township. Yy.V Range /J t4J ('O <br /> o2s3Ccx�) <br /> Original Description(or attach copy): <br /> /fPLSr tP Ss/Czn(I a8d fn I:oy aq � f (J, llagP G-o� 7, 9-, of <br /> a <br /> Current Zoning: Q U Floodplain Y(- Wetlands 70 <br /> Lake,'River Classification: Name of Water Body: <br /> 1 v_J <br /> Shoreland Agreemt or SIPS /N: Farmland Preservation /N: Managed Forestry Law YIN: <br /> New ParcelInformation <br /> Proposed New Legal Description and Parcel Size: it/2<v C S M V� <br /> Acres- <br /> (If parcel is to be surveyed,provide preliminaryf map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> n <br /> Proposed access to public waters to be provided <br /> If ves, describe access: <br /> Signature of Owner: Date: <br /> U� <br /> Signature of Owner: Date: <br /> > Does parcel meet Zoning Requirements? Yes No <br /> o <br /> 0 <br /> > Does parcel require a Survey? Yes No <br /> an <br /> > Permit application fees submitted? Amount S_T_L _Receipt# <br /> m <br /> ❑ Reconciles with Real Property Lister Yes No Date: <br /> a <br /> c <br /> If not,explain: <br /> 0 <br /> G <br /> y <br /> Application: Approved I Denied Reason for Denial: 7019 <br /> NETT COUNTY <br /> Land Use: 7 2 Z / Date: ZONING <br />