Laserfiche WebLink
Fees must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.01 <br /> Survey of Existing Parcel: $50.00flot <br /> and/or Pre-Application Form or Map Review Form Subdivision w1 Sur ey: S200.00+S50.00flot <br /> Owner: � 1 '1 l/;G'/7.- / -o r Buyer: .5 2 <br /> O <br /> G m 7 <br /> Address: O� 7 4:1c/ ' 5 / Address: .° P <br /> 0Set"‘.› 16- &i I --5—(7/0 z0 \ 4) <br /> Phone: ( ._S--i S 474 `(/ n Phone: <br /> OriEinal Parcel Information <br /> Tax ID#: A9 6 / L/- t-SC/ S—S- Section /5 Township yy Range /S <br /> Original Description(or attach copy): S c ' cVa eci �p y f <br /> 0 <br /> M <br /> PUS �� <br /> Cu nt Zoning: _y,i dplain Y/N; Aid Wetlands YIN: A c) Lake/River Class- 11`A <br /> Name o .i•y: Shoreland Agreement/SIPS YIN: <br /> Farmland Preservation YIN: Managed Forestry Law YIN: <br /> lb <br /> New Parcel Information <br /> 1b <br /> Proposed New Legal Description and Parcel Size: A.) f / CS /'''.1 t. <br /> Y * j2 X L> or ,tt XXX xX <br /> Acres• <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Y <br /> X <br /> Proposed access to public waters to be provided YIN: C <br /> og <br /> ac <br /> If yes,describe access: <br /> Signature of O. Date: ti —6 ,2.O 2.Z. <br /> r� <br /> Signature of Owner: Date:.. <br /> Fee Rec:.5'0.00 <br /> No <br /> > Does parcel meet Zoning Requirements? Yes o <br /> El- Check it:/0 00 <br /> > Does parcel require a Survey? Yes No c <br /> 7. <br /> e JReconciles with Real Property Lister Yes No Date: - <br /> If not,explain: o S 1,1 ,j r,. <br /> 0 � l� <br /> Application. .proved / enied Reason for Denial; - 0 CD <br /> Land 'e: -' Date: to <br /> // ZOZZ = N c4 <br /> R• N <br /> N <br /> mITFO <br /> LTJ <br /> A, '.4 <br /> `4 <br /> 9 <br /> y+5� <br /> ,1..)i <br /> 1 T$ <br />