Laserfiche WebLink
Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision wfo Survey: S50.00 <br /> Survey of Existing Parcel: S50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision w/Survey: S200.00+550.00not \, <br /> Owner: � Y e ICA./ a Bu er: re c 3 <br /> C <br /> a z <br /> Address: I Gil 1 PA Ic sj ?OvVin Address: F' o <br /> C_hunha 5Sen Mid 55 3 0 ,D ,) <br /> t~ <br /> Phone: (0 ( 2-- 85 61 9 9 t S Phone: to, <br /> Original Parcel Informations a <br /> Tax ID#: 3 L J <br /> 3 ( Section l TownshipRange /E4 <br /> Original Description(or attach copy): I v (!y — 7 (Ai <br /> c <br /> $ <br /> a <br /> A <br /> n <br /> Current Zoning: Flood lain YIN: �v Wetlands Y/N: /V u Lake/River Clss: <br /> p Body: % <br /> Name of Water Shoreland Agreement/SIPS Y/ AA <br /> Farmland Preservation Y/N: Managed Forestry Law Y/N: /y^N: <br /> c.9 ri <br /> New Parcel Information i , <br /> Proposed New Legal Description and Parcel Size: PCoeOce-.� C-..c AI o`4-1, he ci <br /> Acres c to LP e S <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) „3 <br /> Proposed access to public road: •C c <br /> v <br /> Proposed access to public waters to be provided Y/N: WO <br /> If yes,describe access: <br /> Signature of Owner: — Date: S/2 ?/ ZG 2 5 <br /> Signature of Own( Date: g Z / �� z_ <br /> 1 Fee Rec:0.. 7.60 <br /> ➢ Does parcel meet Zo iv r Yes No i <br /> Check#: 3jf <br /> > Does parcel require a Survey? Yes No 0 <br /> 5. <br /> a <br /> z <br /> 0 <br /> rn <br /> ma <br /> a <br /> Reconciles with Real Property Lister Yes No Date: < <br /> n <br /> soso <br /> If not,explain: <br /> a <br /> 0 <br /> z <br /> r <br /> Applicatio 1 . pproved Denied Reason for Denial, w <br /> bn <br /> rm <br /> Land CTse: Date: <br /> hile - 30- 1 zo cl 3 q. <br />