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'rcry fim t-ft t.:y icr[tts <br /> Burnett County Subdivision Permit Application ,,. .- ,',,- sof ' <br /> ycs1_loq.n Poscrii S-iu <br /> and/or Pre-Application Form 1.1y11k41A .;.. 151ifx}tot ---1:,;, <br /> fx <br /> Jean LLC <br /> t�vrner: Buyer; - <br /> 1, 1111072661st St g <br /> Address: <br /> t. <br /> Ctsisaga City MN 55013 Address; ' <br /> Phone: Phone: . <br /> Oriiinal Parcel Information <br /> : i Parcel Ill a 07-030-2-3& r <br /> 1 -05-5 05-010-018XSrcti�sa 5 Towrccxtiip 3�t'd RaBge 15, � <br /> 0 �, <br /> Original l}t ription(or attach cope): CL 10 g <br /> _ H <br /> 4 Current Zoning; Cl F'ioudplain 'N; N lYctlands YIN: N <br /> _i ake,R3ser Class: <br /> sf Namc orater Bod : N/A Shoreland .Agreenaent'SIPS 1'i : <br /> tFarmland Preserrattack" N NI lklanagcd Forestry Law ' : N <br /> New Parcel information <br /> Proposed Ness Legal Description and Parcel Size: 4 Lot CSM <br /> t <br /> Acres: <br /> (if parcel is to be surveyed,provide preliminary map. See attached for preliminary°map requirements.) <br /> 0-* ( Proposed access to public road: <br /> st <br /> Proposed access to public vs titers to be provided i IN: =s <br /> ` <br /> If tics,describe access: tis" <br /> Signature of&oiler: .. +..__ Date: 4';�/t Ci ) ' Gy 6? y} <br /> Signature of t7tvner: Date; f <br /> C <br /> t +cs parcelmeet 7nxn Requirements) Yetihyo <br /> f,}ei part-cc'require u Sure.' res No <br /> '° <br /> i Permit applicant:in fees-submirtecP 0 Amount$ Receipt F:. -• <br /> _ <br /> 1-----] <br /> N Reconciles with Real Property Lister S+tis") No Date <br /> r <br /> II not.explain <br /> Li <br /> tY Application: V%4 i ,ird , Denied Reason for Denial: <br /> 22__,22. _____.___ _ <br /> Land Use. _._ ,'nate: <br /> .n.,:c4,1,,,,,„4.-',4 . ; .;.r a . .s :...�...ak . ..„ a..,t°l.�*s.a -+4 <: mAa� � 4d .z <br /> li /44.44....._ Aida <br /> .A, I / p <br /> Ze? <br />