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ECIEDVIED <br /> i <br /> /1 U aAuthentisign ID:18753470-41FD-4141-8654-E713EDC848B7 LA; 0 2'01 <br /> •P50 <br /> Burnett County Subdivision Permit Application iv '' t ep $n` <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 /> b <br /> Owner:Ao f ,•is7r-.-. r 12;hs4),‘L+U3uyer:"r y S - /`1<W,Ilia ty.5 <br /> Address:. 2 Yl etc! .2" Address: C P 5 6r ea,(ems f ) r• o <br /> rn <br /> Lc/e.6 s r tom : s-Y8 93 eG`ci r. ./4 Y\ <br /> Phone: 7/5--733 - e i/•3 Phone: 6 /� —Z 0? — 6 ye f <br /> Original Parcel Information bQ <br /> Parcel ID#: 0 7-p i e,i- c c,��C.,t©ec, NV <br /> $-Z^3 y-/G -l g-1 Section f� Township 9/V Range/4 W <br /> O <br /> Original Description(or attach copy): .A'0 A/ i= e <br /> to <br /> %T x r' //SSs <br /> P i <br /> , <br /> Current Zoning:A a-Floodplain YIN: /"J Yetlands Y/N: / _ Lake/River Class:_A/if <br /> ,); Name of Water Body: Shoreland Agreement/SIPS YIN; <br /> m Farmland Preservation YIN: /t/ Managed Forestry Law YIN: it/ <br /> a <br /> New Parcel Information 7 <br /> Proposed New Legal Description and Parcel Size: LC./ yt /V /V 6 <br /> Acres: / /, ep 7 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) d <br /> Proposed access to public road. ! et-:r j r c ^0S 1 o c..J Aa\ <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: <br /> putrtattru 08/06/2021 <br /> Signature of Owner; Xxietea 1.`.R:rorman Kristen J. Rinnman Date: <br /> Signature of Owner 8/6/2 02 1 3:59:37 PM CDT Monte J. Rinnman 08/06/2021 <br /> ,tra..r,7 4ty.. ,. Date: <br /> 8/620214:00:38 PM CDT —_ <br /> fl Does parcel meet Zoning Requirements? Yes No tj'1 <br /> - <br /> oN > Does parcel require a Survey? Yes No cr <br /> a <br /> via ➢ Permit application fees submitted? 0 Amount$ Receipt# <br /> ®Reconciles with Real Property Lister ) No Date: %/ .4/a_ -Lc( j Art, <br /> r <br /> a If not,explain: <br /> l <br /> n <br /> O <br /> C. <br /> d, Application. pprove / Denied Reason for De al: <br /> Land Use: Zao Zr Date: <br />