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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/oServey: $50.00 <br /> and/or Pre-A lieation Form Survey of Existing Parcel: $50.00/lot <br /> pp Subdivision w1 Survey: $200.00+$50.00/lot <br /> Owner: Paul M Volker Trust Buyer: <br /> b <br /> Address: 1327 140th Ave NW Address: <br /> Andover MN 55304 <br /> c. <br /> Phone: 763-614-9914 Phone: • tO <br /> >U <br /> Original Parcel Information N <br /> t <br /> Parcel ID#: 07-032-2-41-16-36-5 05-001-018100 Section 36 Township 41N Range 16W <br /> cN <br /> Original Description(or attach copy): Lot 1 CSM#4801 V27 P1 GL 1 <br /> a <br /> ee <br /> `I <br /> r <br /> Current Zoning: RR2 Floodplain YIN: Y Wetlands Y/N: N Lake/River Class: <br /> 1 Name of Water Body: Minerva Lake Shoreland Agreement/SIPS YIN: a <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> anon <br /> Proposed New Legal Description and Parcel Size: 1-'131- C 5/1Y) <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C <br /> a <br /> Proposed access to public waters to be provided YIN: <br /> If yes,describe access: ' A <br /> �/ -fin <br /> Signature of Owner: J Date: 7L� ��Z� )J' <br /> Signature of Owner: Date: c <br /> a <br /> b <br /> > Does parcel meet Zoning Requirements? Yes No ‘e6 35---- <br /> i9 <br /> N <br /> > Does parcel require a Survey? Yes No <br /> g. <br /> Dv <br /> > Permit application fees submitted? 0 Amount,$ 3D�` _Receipt# <br /> ®Reconciles with Real Property Lister en No Date: 8/¢/c9oZ <br /> If not,explain: <br /> 0 <br /> 0 <br /> Applicatio pproved Denied Reason for Denial: <br /> Land Use: - �� � g' 10%e)a?nate: <br /> Use: <br />