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I. <br /> t <br /> I <br /> Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50 00 <br /> Survey and/or Pre-Application Form or Map Review Form Subdivision ww/Serum Parcel: <br /> $200 00-$50,0011ot <br /> Owner: Brian & Debbie Kelly 0 A <br /> Buyer. m i <br /> Address:15425 Dresden In PP C <br /> Address• _ c <br /> Apple Valley MN 55124 <br /> 15- IF <br /> Phone: Phone: 0 <br /> Original Parcel Information N t <br /> Tax ID#: Secti on <br /> 07-010-2-38-19-15-2 01-000-012000 15 Township 38Nmange 19W W <br /> I� Original Description(or attach copy):NE-NW ex W 32rds&ex E 100'of N 300' <br /> i <br /> R <br /> Current Zoning: RR1 Floodpiain Y/N:Y Wetlands YIN:Y LakeJRiver Class '1F,.1 <br /> Name of Water Body:Hay Creek <br /> Shoreland Agreement/SIPS Wit <br /> Farmland Preservation Y/N:N Managed Forestry Law Y/N: NT' <br /> k <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: 4 lot CSM <br /> Acres <br /> (If parcel is to be surveyed,provide preliminary map. See attached for reli <br /> P minm7'map requirements.) H <br /> Proposed access to public road: <br /> Eil <br /> Proposed access to public waters to be provided Y/N: <br /> 4-4.. <br /> If yes,describe access <br /> Mk— <br /> > Does parcel meet Zoning Requirements? Yes No Fee Rec: 322,m— <br /> Check#: aos1'Z <br /> > Does parcel require a Survey? Yes No <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> W. <br /> rt <br /> A 6cati <br /> pp APProVed / flied Reason for Denial: <br /> Land Use. � 7 3 <br /> Date: <br /> 4- <br /> n v44 VD / "pcf y e_y/-; <br />