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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 /> b <br /> Owner: Bruce & Kathleen Drouillard Buyer: <br /> C7 �' <br /> Address:1422 Fairview Dr Address: n <br /> Faribault MN 55021 <br /> N <br /> Phone: Phone: <br /> Original Parcel Information <br /> Tax ID#: _07-012-2-40-15-12-5 15-750-043000, Section 12 Township 40 Range 15 <br /> 044000, 045000 <br /> Original Description(or attach copy): Lots 35-37 Treasure Island Add to W <br /> Current Zoning: PUD Floodplain Y/N:N Wetlands Y/N: N Lake/River Class: <br /> Name of Water Body: 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: CSM to combine existing lots <br /> Acres <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: 77 <br /> r.. � `V\ <br /> Fee Rec: o� <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> 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 />