Laserfiche WebLink
SQ (>% �' Dc�e r e av✓L �� u a S al s 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/Survev: $200.00+$50.00/lot <br /> to <br /> Owner: /�Ct Pl Buyer: <br /> Address: ct1 Address: <br /> Phone: 7�S — �cj� _ CDCG Phone: <br /> Original Parcel Information <br /> Parcel ID#: 200(9 3$`7�710,00W It#o0 Section � Township 3gA) Range V_ m <br /> Original Description(or attach copy): 1) C N E S <br /> w <br /> Current Zonin Floodplain Y& Wetlands YQ Lake/River Class: <br /> > Name of Water Body: Shoreland Agreement/SIPS <br /> -c `,� <br /> Farmland Preservation Managed Forestry Law 46 <br /> New Parcel Information / ) <br /> Proposed New Legal Description and Parcel Size: � >C_L e w <br /> L <br /> at ✓l 2 G' F i,Q_ OINAd <br /> - ' <br /> � Acres: '•° <br /> c� <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road* <br /> Proposed access to public waters to be provided Y/N: <br /> ^e <br /> If yes, describe access: <br /> Signature of Owner: Date: Ia/ �/ <br /> Signature of Owner: ' Date: !/}—�—G 6 <br /> Does parcel meet Zoning Requirements? Yes No <br /> N ➢ Does parcel require a Survey? Yes No <br /> 0 <br /> 0 h <br /> Permit application fees submitted? Amount$ J .QD Receipt# <br /> fJ Reconciles with Real Property Lister 6-es'), No Date: <br /> If not,explain: <br /> z <br /> .application: enied Reason for Denial: DEC — Q 2016 <br /> Land Lse: � � 7��o Date: BURNETT <br /> ttt � <br /> ZONING <br />