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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form or Map Review Form Subdivision w o Survey. 550.00Survey of Existing Parcel: S50.00'lot <br /> Subdivision w Survey: S200.00+S50 00:lot <br /> Owner: Ronald & Cynthia Yourchuck Buyer: <br /> 24735 OLD HVVY 35 g <br /> Address:_s,_R_E _57 Address: <br /> 2. <br /> Phone: -, ^r _ 's Phone: <br /> Original Parcel Information ` <br /> Parcel ID#: 0302306017 I 0 Section 6 Township 38 Range 15 T <br /> a <br /> et <br /> Original Description(or attach copy): North 20 Acres of Gov. Lot 2 <br /> 5 <br /> Current Zoning: RR-1 Floodplain YIN: N Wetlands YIN: N Lake/River Class: WA <br /> .a Name of Water Body: _ Shoreland Agreement/SIPS YIN: N <br /> Farmland Preservation YIN: N \lanaged Forestry Law Y/N: N <br /> o <br /> T New Parcel Information P' <br /> Proposed New Legal Description and Parcel Size: <br /> A CSM is used to divide into lots o <br /> Acres: 1 1.4 A and 80A <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Direct to Airport Rd & Old 35 to <br /> ° <br /> to <br /> eD <br /> )43 <br /> Proposed access to public waters to be provided Y/N: N .. <br /> N <br /> If yes,describe access: <br /> Signature of Owner: rt`!r. �lc Y ��A� Date: <br /> o <br /> signature of owner: uate: 3 <br /> Ts <br /> c <br /> > Does parcel meet Zoning Requirements? Yes No -I <br /> N ➢ Does parcel require a Survey? Yes No co <br /> o 35a, � 1 i 7E. <br /> �° <br /> Permit application fees submitted? 0 Amount$ 'Th <br /> EVE i V i NI <br /> 0 Reconciles with Real Property Lister Yes No Date: <br /> o If not,explain: _ L F 12 20211 <br /> a. <br /> Bur rlelt County <br /> Land Services Department <br /> a, Application pproved enied Reason for Denial: _ <br /> Land Use: Date: <br /> l zoo- <br />