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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 or Map Revievy Form .Subdivision w/Survey: $200.00+$50.00/lot <br /> Owner: ID <br /> Andrew&Emily Zaccardi c <br /> n <br /> $uyer: N <br /> 5463 Erickson Rd m Q <br /> Address: Address: . <br /> Mounds View MN 55112 1 <br /> 651-675-7480 <br /> Phone: Phone: <br /> Original Parcel Information 0 <br /> Tax ID 07-032-2-41-16-28-5 15-004-055000&056000Section 28 Township 41 N Range 16W <br /> Original Description(or attach copy): Plat of Danbury Bik 4 Lots 1 2-1 3 <br /> O <br /> r <br /> ii <br /> Current Zoning: RR2 Floodplain YIN: N Wetlands Y/N: N Lake/River Class. <br /> Name of Water Body: NIA Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation YIN: N Managed Forestry Law YIN: N <br /> New Parcel Information is <br /> Proposed New Legal Description and Parcel Size: V ' 4 <br /> n <br /> Acres: ... <br /> 1 <br /> i <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) y <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: r 1 <br /> InIf yes,describe access: <br /> .441: 6/16fri It 16 ,I <br /> .s,,sop,',:---igrk,,o. _------ , ....„....„.....,----- <br /> .4 v <br /> arii.-440.40440: - <br /> .., 6-u-9.02zFee Rec:'�,t^ 1 <br /> > Does parcel meet Zoning Requirements? Yes N© Cheek#:C�o79�' <br /> > Does parcel require a Survey? Yes No a <br /> 1 <br /> Reconciles with.Real Property Lister CO No Date: : <br /> If not,explain: <br /> Applicatio Approved I D nied Reason for Denial: <br /> La fse. Date: <br /> 6 Z_DZ <br />