Laserfiche WebLink
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+$50.00/lot <br /> V <br /> 'eD <br /> � <br /> Owner: JO/Telt /*e_____,Buyer: f9 <br /> C <br /> w <br /> ▪ z <br /> Address: Address: `D <br /> • cA <br /> Phone: Phone: 'c!P-- <br /> Original Parcel Informati n Z <br /> to�l� z�3z }� // <br /> Tax ID#: Section Township ange <br /> Original Description(or attach copy): <br /> j,c rWS c 2635'1,Z43$O, Z7//9, Z638a, Z63821 22V-e 0 <br /> a <br /> pa N e.- N <br /> Current Zoning: 1 Floodp ain Y/N: Q Wetlands Y/N: � Lake/River Class: <br /> 14- <br /> ob <br /> Name of Water Body: ilVhQ1 1,;(1-(A.-- Shoreland Agreement/SIPS Y/N: .,‘ <br /> Farmland Preservation Y/N: !! Managed Forestry Law Y/N: <br /> New Parcel Information <br /> s /� g -- Are"/'IAA <br /> Pro osed w Legal Description and Parcel Size: W 4 , <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) Y <br /> Proposed access to public road: k <br /> u a , <br /> f fI 1�u► <br /> Proposed access to public waters to be provided Y/N: Yt <br /> 5 -- !9l G et CG2S� aW <br /> If yes,describe access: N e J <br /> W W <br /> Signature of Owner: Date: 0 t' 1 cit <br /> qt <br /> Signature of Owner: Date: <br /> H Fee Rec:3/900 <br /> > Does parcel meet Zoning Requirements? Yes No m <br /> 7 Check#:�Z2c <br /> ➢ Does parcel require a Survey? Yes No 6 c"er----;'s-6 rc� ` <br /> z <br /> ° fr Dv t'y..I) f r/K. <br /> pis— <br /> Reconciles with Real Property Lister Yes No Date: <br /> r <br /> m <br /> H <br /> If not,explain: <br /> o � <br /> z l Q, <br /> fi <br /> �,p �d. by <br /> Application Approved / Denied easo r Denial; Q�I <br /> Land Use: Date: 0/2eW rri i <br /> n ri ADI 6 �AqL Ilse_ o <br /> 1'v�c-�l iM�uar 4 yy � rL 91s12�Z3 <br /> 1M Mr'� P ©ti 9 y zoz , <br />