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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 fD <br /> Owner: Ronald &Jean Pearson Living Trust .: Jane Tomnitz <br /> Address:784 Torchwood Dr Address: 28315 Johnson Lake Rd o <br /> St Paul MN 55112 Webster WI 54893 ce <br /> Phone: Phone: j"k <br /> Original Parcel Information <br /> Tax ID#:07-020-2-40-16-23-5 05-007-018000 Section 23 Township 40N RAnge 16W (b�� <br /> 07-020-2-40-16-23-5 05-007-011000 A5 <br /> Original Description(or attach copy): GL 7 & Lot 2 CSM V13 P88 <br /> O <br /> a <br /> e, <br /> `1 <br /> Current Zoning: RR 1/A2 Floodplain Y/N:Y Wetlands Y/N: Y Lake/River Class. <br /> N <br /> Name of Water Body:Johnson Lake Shoreland Agreement/SIPS Y/N: ,` <br /> Farmland Preservation Y/N: N Managed Forestry Law YIN: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM 'P <br /> r. <br /> Acres: I, <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) \yy <br /> Proposed access to public road: k <br /> C <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe acce • <br /> GI <br /> • <br /> Fee Rec:99/O--d <br /> > Does parcel meet Zoning Requirements? Yes No <br /> ' Check#: 99Q/ <br /> > Does parcel require a Survey? Yes No <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> Applicati : Approved / enied Reason for Denial: <br /> Land Us . Date: <br /> 3 ? zf <br />