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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 Review Form Subdivision w/Survey: $200.00+$50.00/lot <br /> owner: Timothy Paulno Buyer: Travis &Autumn Ryan <br /> d <br /> Address: 14909 Anson St NE Address: 6333 Clinton Ave o <br /> Columbus Mn 55025 Minneapolis MN 55423 <br /> ,ate <br /> Phone: 612-221-2684 Phone: <br /> Original Parcel Information <br /> f>ri-02•Ca-a-U p- Cl-fib-5 I 5-44ao—03013a <br /> Tax ID#: 07-036-2-40-17-36-5 15-420-030121 section 36 Township 40N Range 17W <br /> 07-036-2-40-17-36-5 15-420-040004 <br /> Oricinal Description(or attach copy): <br /> �-4 C 5'h VW1 P 4b d- Lakeview Hts Lt 2-5 Blk 4&vacated roads 0 <br /> Current Zoning: RR1 Floodplain Y/N:N Wetlands Y/N: N Lake/River Class. <br /> Name of Water Body:N/A Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N:N Managed Forestry Law Y/N: N <br /> New Parcel Information • <br /> Proposed New Legal Description and Parcel Size: aLot CSM <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: *k <br /> If yes,describe access: <br /> • <br /> _Travis T�avtan2 241443csTan <br /> Jan 24,2024 <br /> Fee Rec: <br /> > Does parcel meet Zoning Requirements? Yes No Check#: <br /> > Does parcel require a Survey? Yes No <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> Application: Approved / Denied Reason for Denial. <br /> Land Use: Date: �` <br />