Laserfiche WebLink
• Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision w/Survey: $200.00+$50.00/lot <br /> ro <br /> i _'0Ck ?i kvs sic c ; <br /> Owner: Buyer: ro 1 <br /> V <br /> Address: V1014i. Address: 14 <br /> ° c <br /> ivoaic k'-), 1&Je�s /, I m <br /> w <br /> Phone: 7/c" �7 9 /-7em Phone: <br /> o N <br /> � <br /> j Original Parcel Information �� N <br /> Tax ID#: 5-4/7 1 Section Q3 Township Range /5 <br /> Original Description(or attach copy): SEE ( Ci) 0 <br /> :t <br /> r <br /> iDAz RR-3Ni 1 <br /> Current Zoning: Floodplain YIN: Wetlands Y/N: Lake/River Class: d <br /> Name of Water Body: ( 1 fQ '� 10. Shoreland Agreement/SIPS YIN: ! V ` <br /> n1\1 Farmland Preservation Y/N: 1 v) Managed Forestry Law Y/N: r <br /> New Parcel Informationt' <br /> Proposed New Legal Description and Parcel Size: )01- C SVA <br /> Acres: I I. J 2 <br /> 6 i-fri <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: '- <br /> X <br /> Proposed access to public waters to be provided Y/N: C <br /> If yes,describe acceSs r <br /> . . ) lor, , <br /> Signature of Owner: -rn.,., ., Date: .0 : ...I <br /> Signature of Owner: / t� 1 Date: 7'd.1 <br /> Fee Rec:3CX]` ' <br /> ➢ Does parcel meet Zoning Requirements? Yes No x Check#: 04,5 <br /> c <br /> ➢ Does parcel require a Survey? Yes No 0 <br /> rri <br /> Reconciles with Real Property Lister No 7/' <br /> No Date: 7/c ` <br /> a a� <br /> If not,explain: a m g r <br /> oITal <br /> U) <br /> .0 N c_ N <br /> O <br /> Applicatio I Approved Denied Reason for Denial. �'Z ^'„ <br /> rt m 511 <br /> Land Us • Date: m <br /> 072e2.-Z__ d ,-.1) <br />