Laserfiche WebLink
Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: 550.00 <br /> and/or Pre-Application Form Survey of Existing Parcel: S50.00Aot <br /> �[pp Subdivision wl Survev: $200.00+550.00/lot <br /> p� <br /> Owner: _ M ( crd [ Buyer: ti <br /> Address: ld &41tGrM /W Address: 3 <br /> ra h i <br /> it/ iyod <br /> 7/5- 1 - �9�N <br /> Phone: Phone: <br /> 03y-9 6- 0100 Oriainal Parcel Information <br /> � <br /> 3N_grz�,- 0 0p p3�/V Range/ <br /> Parcel ID#: 0 3 — r< Z 9' 6/ _Section / Township <br /> Original Description(r attach c1.766 �! o�– O <br /> 242T dr_ h&,Z- E5hZ0 — RLL oL Lam 8 dSl <br /> V <br /> n p 1 <br /> TCurrent Zoning: /v 2 FloodplainDN: �nWetlands N: - <br /> Lake/River Classification: Name of Water Body: Hyl /Y <br /> Shoreland Agreemt or SIPS Yk_Farmland Preservation Y®_Managed Forestry Law Y0_ <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> Acres: O• �� <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: rae& 4xel& C <br /> Proposed access to public waters to be providedY® A <br /> �. <br /> If ves,describe access: <br /> N Signature of Owner: 9,1.4 � SGM%+41- kDate• 2 �� <br /> o+ -`(I� 9—t6Je a4 t G­1 *1<-� I Ge <br /> °Q Signature of Owner: Date: o <br /> 3 <br /> 9 <br /> D Does parcel meet Zoning Requirements? Yes No ° <br /> A <br /> Does parcel require a Survey? Yes No w o 0 <br /> CL t t J W <br /> Permit application fees submitted? ❑ Amount$ Receipt# °W' <br /> c – s. <br /> °• ai <br /> ^ ❑ Reconciles with Real Property Lister Yes No Date: o ' <br /> Ido <br /> If not,explain: pFz <br /> rDO <br /> o f <br /> Application: A /r�o(� //Denied Reason for Denial: See mid (/l�rly� o o <br /> �o <br /> Date: <br /> Land Use: 9 Oy ' <br />