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 /> �] f 1 t a <br /> b <br /> Owner: J C`sLYA+ ( \I�li�V I Q 5 140.)k y Buyer: �I''�"c t c�� -A- �G� Vk ST'�\v►',`j ei 9 <br /> l7 �* <br /> 7 C'f ,. Z <br /> Address: y 7� I Air Address: y / 2 <br /> uj0e,3 -, wr 6 cl S9 3 w6s 100 z, Sv5-`i3 <br /> '-')/-- /c N <br /> Phone: 7/Jr' S Lc / Phone: ( CJ 00 - j w <br /> Original Parcel Information <br /> Tax ID#: / 5 7° Section6't Township Range / / <br /> Original Description(or attach copy): <br /> O <br /> a <br /> eD <br /> C._.. <br /> f <br /> Current Zoning: AA Floodplain Y/N: KtiWetlands Y/N: Lake/River Class: <br /> Name of Water Body: {V 4 Shoreland Agreement/SIPS Y/N: J -�- <br /> Farmland Preservation Y/N: Managed Forestry Law Y/N: " <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> Acres: 1 0 cif 5 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) yY <br /> Proposed access to public road: C - <br /> d <br /> Proposed access to public waters to be provided Y/N: A! <br /> If yes,describe access: 00 <br /> Signature of Owner: C_"4` - _ Date: 7-02 `' UO 3 d <br /> Signature of Owner: Date: <br /> , Fee Rec <br /> 05,0 <br /> ➢ Does parcel meet Zoning Requirements? Yes No E Check#: <br /> ➢ Does parcel require a Survey? Yes No ° 16�z <br /> r <br /> a <br /> ° <br /> —� <br /> a <br /> Reconciles with Real Property Lister Yes No Date: jl OLI z _ �� <br /> y a uuij <br /> (. <br /> If not,explain: a < ,CD to f� <br /> z <br /> z <br /> r �o rn o <br /> C c4 <br /> Application: Approved / enied Reason for enial: ) 07x <br /> a.< N <br /> Land U r �% V 1' !Nt� !'I 4 Date: / 0 Z m U U <br /> a <br /> rt <br />