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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 2Q0 <br /> Survey of Existing Parcel: $50.00/lot " <br /> and/or Pre-Application Form Subdivision w/Survey: $200.00+$50.00/lot <br /> Owner: William Sandberg Buyer: <br /> b <br /> eo <br /> 6 Red Cedar Lane '` <br /> Address: Address: <br /> Minneapolis MN 55410 0 <br /> :.1 <br /> Phone: Phone: C <br /> Original Parcel Information 4 <br /> N <br /> 07-038-2-41-14-16-5 15-515-021000,022000,023000,024000 <br /> Parcel ID#: Section 16 Townshi 4p 1 N Range 14W Cw�� <br /> Original Description(or attach copy): Noble Pines Lots 11-14 O <br /> a <br /> Current Zoning: RR1 Floodplain Y/N: Y Wetlands Y/N: Y Lake/River Class: <br /> a: Name of Water Body: Webb Lake Shoreland Agreement/SIPS Y/N: <br /> a <br /> '. Farmland Preservation Y/N:N Managed Forestry Law Y/N:N <br /> New Parcel Information <br /> t• <br /> j. <br /> Proposed New Legal Description and Parcel Size: CSM 4 lots <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C <br /> d <br /> Proposed access to public waters to be provided Y/N: "� <br /> If yes,describe access: <br /> Signature of Owner: k) / Date: 6 �� <br /> Signature of Owner: Date: 0 <br /> B <br /> .o <br /> e.2-#-6060 a <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N .1 <br /> o > Does parcel require a Survey? Yes No <br /> 5 p W <br /> °q ➢ Permit application fees submitted? D Amount$ 2.49�i Receipt# IV <br /> C, ❑Reconciles with Real Property Lister Yes No Date: <br /> a <br /> O: If not,explain: N <br /> cOSn <br /> 0 <br /> .s <br /> a W r <br /> P e <br /> Applicatio•. •pproved / 1 enied Reason for Denial: N it <br /> Land Use: '"illir Date: t'�z?„,__ <br />