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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 Subdivision w/Survey: $200.00+$50 00/lot <br /> Owner: Maximilian Steininger Buyer: _ b <br /> e <br /> Address:3070 S Lexington Ave Address: <br /> Eagan MN 55121 <br /> 651-425-8072 <br /> Phone: Phone: a� <br /> Original Parcel Information <br /> Parcel ID#: <br /> 07-020-2-40-16-23-5 61098•10101.4*&05 003-017000 Section 23 TownshijON Range 1 6W <br /> Original Description(or attach copy): Gov Lot 4 ex W 66' & Prt of GL 3 Lyg S of CSM V7 P273 <br /> • <br /> Current Zoning: RR2 Floodplain Y/N: Y Wetlands Y/N: Y Lake/River Class: <br /> • <br /> Name of Water Body: Johnson Lake Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM change existing lot lines SLAAceu A k— <br /> tc, <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> a <br /> et <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: <br /> ry <br /> Signature of Owner: , Date: <br /> Signature of Owner: Date: <br /> ➢ Does parcel meet Zoning Requirements? Yes No cY'p <br /> -s <br /> N � <br /> ➢ Does parcel require a Survey? Yes No <br /> p� <br /> 0° > Permit application fees submitted? 0 Amount$ �0O, O Receipt# <br /> m 0 Reconciles with Real Property Lister Yes No Date: <br /> o � <br /> If not,explain: <br /> cN <br /> i o <br /> n- <br /> Applicati Approved /)toenied Reason for Denial: <br /> 7 - <br /> Land Use: 00e —Date: <br />