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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: $50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survey: S200.00+S50.00not <br /> Owner: Thomas&Kathleen Mueller Buyer:Bu <br /> y • *es <br /> ED <br /> 3815 Saratoga Ln <br /> Address: Address: <br /> r. <br /> Plymouth MN 55441 P <br /> :.c1) <br /> Phone: 651-590-1980 Phone: 05 <br /> Original Parcel Information <br /> 07-012-2-40-15-11-5 15-725-065000 <br /> Parcel ID#: 064000.063000.062000 Section 11 Township 40N Range 15W p <br /> O.l <br /> Original Description(or attach copy): Tall Moon Addition to Voyager Village Lots 52-55 <br /> A <br /> mo Current Zoning: PUD Floodplain Y/N: N Wetlands Y/N: N el <br /> Lake/River Class: <br /> ,to <br /> p Name of Water Body: N/A Shoreland Agreement/SIPS Y/N; P <br /> .. Farmland Preservation Y/N: N Managed Forestry Law Y/N: N rfi <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM combine lots <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C <br /> m <br /> p <br /> Proposed access to public waters to be provided Y/N: •i <br /> If yes,describe access: <br /> ` Date: F(22-122 i' <br /> Signature of Owne . Date: . Q>I as o <br /> 8 <br /> b <br /> > Does parcel meet Zoning Requirements? Yes No C 0—6 07111 <br /> 7111 <br /> a <br /> gl ➢ Does parcel require a Survey? Yes No ,v 7 <br /> DO l <br /> Permit application fees submitted? 0 Amount$ 3 O Receipt# v V+ <br /> \a Ss <br /> ❑Reconciles with Real Property Lister Yes No Date: al w <br /> so. <br /> If not,explain: � l <br /> r <br /> 0 <br /> at <br /> Applicationr red / Denied Reason for Denial: Ni, vi <br /> ---j <br /> ,� 7e r!i/ZOZ. <br /> Land Use: yi,.,,r,—( _i` �� Date: <br />