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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 Subdivision w/Survey: $200.00+$50.00/lot <br /> Owner: Oluwatosin Patricia Ojo Arndt Buyer: -a <br /> Address: 1702 Howard St N Address: 3 <br /> Maplewood MN 55109 P <br /> Phone: 612-501-4308 Phone: <br /> Original Parcel Information 41 <br /> 07-012-2-40-15-23-5 15-795-027000 <br /> Parcel ID#: 07-012-2-40-15-23-5 15-795-028000 Section 23 Township 40N Range 15W <br /> C <br /> Original Description(or attach copy): Lots 17 & 18 Viking Hill Addition to VV <br /> C <br /> k <br /> .,..,N <br /> .o Current Zoning: PUD Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: <br /> 19) <br /> 5 Name of Water Body: N/A Shoreland Agreement/SIPS Y/N: y` <br /> Farmland Preservation Y/N:N Managed Forestry Law Y/N:N ) <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM combine 2 existing parcels4: <br /> F\ <br /> Acres: <br /> :::9 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) O • <br /> Proposed access to public road: 3:5Zig d <br /> Proposed access to public waters to be provided Y/N: ..±d.. fp''.If yes,describe access: 1 �� <br /> Signature of Owner: `,Z� • i Dat�7/l8/2022 <br /> Signature of Owner: Date: <br /> .n <br /> a <br /> > Does parcel meet Zoning Requirements? Yes No 4 j 606 KS' A <br /> 7 > Does parcel require a Survey? Yes No <br /> S <br /> °rO > Permit application fees submitted? ❑ Amount$ .�/ ' Receipt# <br /> . --1) <br /> ®Reconciles with Real Property Lister ® No Date: side to <br /> If not,explain: <br /> g:j 00o <br /> n tis <br /> . 0 <br /> y <br /> Applicatio i A A. 'roved ! •nied Reason for Denial: <br /> ' <br /> Land Use: Date: Ar to Z <br />