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Authentisign ID 42151952-E7E6-EE11-AAF0-6045BDDAA143 <br /> 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: S200.00+$50.00/lot <br /> 5 <br /> 1 Owner: - r bA.i)0r 0, )) Buyer: A <br /> `� <br /> Address: `Il ��' �) �a� Are S A o <br /> ' c--te\r-\ \u y M N 5tS g., , <br /> °x 14Phone: Phone: <br /> Original Parcel Information IV <br /> Z`' <br /> _ t, s �0 <br /> Tax ID#: 1LT.v'- y Section( Township ange 1`1 <br /> P 1 P �1, <br /> Original Description(or attach copy): \O j1 K <br /> [� P � <br /> Current Zoning: ► e ciil Floodplain Y/N: .. Wetlands Y/N: �[1s Lake/River Class•\) 'A y v. <br /> Name of Water Body: ; Shoreland Agreement/SIPS YIN: lw+' <br /> Farmland Preservation Y/N: Managed Forestry Law Y/N: N j to <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: 1i ra t1v , �"y NJ\\ <br /> Acres.105 CAP(PzN ecie <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 5 <br /> Proposed access to public waters to be provided Y/N: yu <br /> If yes,describe access: 6', <br /> ''' '- 03/20/24 <br /> 4 ! 7 l, 9 `.aa.p:t <br /> Fee <br /> > Does parcel meet Zoning Requirements? Yes No <br /> Checkk#: Gi54/1/4.- <br /> > Does parcel require a Survey? Yes No <br /> Reconciles with Real Property Lister 1110 No Date: 31211 <br /> 20 y r— <br /> zv <br /> MI <br /> Q = <br /> If not,explain: @ W 3> <br /> m - N <br /> CA <br /> 0o <br /> CD c <br /> Application: pproved / enied Reason for Denial: w <br /> .a- <br /> Land Use: z <br /> frt"-- <br /> / / Date: <br /> � zy CC <br />