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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form or Map Review Form Subdivision wo Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> Subdivision w!Survey: $200.00+550.00/lot <br /> Daniel Howland <br /> Owner: Buyer: <br /> Address: 2728 W. River Parkway Address: 2 <br /> Minneapolios, MN 55406-1840 <br /> 612-339-8811 <br /> m <br /> Phone: Phone: <br /> Original Parcel Information <br /> Parcel ID#: 07-026-2-39-15-28-5 C. .,34-018100 Section 22 Township 41 Range 15 <br /> Two Parcels described in Document No. 475836 <br /> Original Description(or attach copy): =° <br /> and the West Half of Gov. Lot 2, except CSMs V.1 , p.208 and V.1 , p.209. <br /> c,' <br /> Current Zoning: RR-2 Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: N/A ,\ <br /> Name of Water Body: Lake 26 Shoreland Agreement/SIPS Y/N; N <br /> 6 <br /> Farmland Preservation Y/N: [C <br /> N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: We are submitting a CSM that <br /> merges these two parcels into one lot. <br /> Acres: 7.08± <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Direct access Lake 26 Road <br /> Proposed access to public road: °' <br /> Proposed access to public waters to be provided Y/N: N <br /> If yes,describe access: <br /> Signature of Owner: N/A Date: N <br /> n <br /> signature of owner: Pate: <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N ➢ Does parcel require a Survey? Yes No <br /> Permit application fees submitted? 0 Amount$ Receipt# •� <br /> 0 Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> o. <br /> A <br /> o � <br /> a Applicatio . Approved / enied Reason for Denial: <br /> Land Use: / zez Date: <br />