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Fees(must accompany tom): <br /> Burnett County Subdivision Permit Application Subdiv cion w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form Subdivision w/Sutvev: $200.00+$50.00/lot <br /> Robert James Grilz , Jr. <br /> Owner: Kevin W & Jean Ernst Buyer: Sandra Lvnn Bowan y <br /> Address: 7628 County Road D Address:2960 Galtier Street S <br /> z <br /> Webster WI 54893 Roseville MN 55113 <br /> UJ <br /> Phone: 715-866-7330 Phone: 651-4R4-9301 <br /> Original Parcel Information d <br /> J <br /> ParcelID#: 018-3320-03 900 Section 20 Township 39 Range 16 <br /> O <br /> Original Description(or attach copy): See Attached Quit Claim Deed#270897 m <br /> 'o C <br /> o Current Zoning: Floodplain YIN: N Wetlands Y/N: N S <br /> Lake/River Classification: n/a Name of Water Body: CI <br /> Shoreland Agreemt or SIPS YIN: N Farmland Preservation YIN: ]_Managed Forestry Law YIN:_N � <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: See Attached Exhibit B <br /> Cn <br /> 29 Acres <br /> Acres: 29 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: County Road D C <br /> m <br /> Proposed access to public waters t be provided Y/N: n/a <br /> Qj <br /> If ves,describe access: <br /> J <br /> Signature of Owner: Date: <br /> O <br /> Signature of Owner: Date: o <br /> 3 <br /> ➢ Does parcel meet Zoning Requirements? Yes No A <br /> ➢ Does parcel require a Survey? Yes No <br /> as <br /> C>_ <br /> Permit application fees submitted? ❑ Amount$ \50 ' 00 Receipt# C <br /> W <br /> t ❑Reconciles with Real Property Lister Yes No Date: W <br /> a � <br /> If not,explain: o <br /> n O <br /> a <br /> y I <br /> O <br /> Application• Approved enied Reason for Denial: o <br /> Land Use: Date: <br />