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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: Gregory & Sandra Oman Buyer: s <br /> C7 '* <br /> Address:6639 3rd Ave S Address: c <br /> Richfield MN 55423 <br /> w N <br /> Phone: Phone: Y, <br /> Orieinal Parcel Information ?` <br /> 34022 25 ; 41 6 <br /> Tax ID#: Section Township Range <br /> Original Description(or attach copy): Lots 25-26 First Add to Selma Lea Acres <br /> Current Zoning: RR2 Floodplain Y/N:Y Wetlands Y/N: N Lake/River Class: <br /> Name of Water Body: Burlingame Lake Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> New Parcel Info ' ation <br /> Proposed New Legal Description and Parcel Size: CSM to combine 2 existing lots <br /> i <br /> Acres: <br /> I y <br /> (If parcel is to be surveyed,provide preliminary map. See z ttached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: <br /> 62 <br /> up <br /> Fee Rec: 527• <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> Check#: G 1 ZO <br /> ➢ Does parcel require a Survey? Yes No <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> Application: Approved / enied Reason for Denial- <br /> Land Use- Date: <br /> S' l3 ZOz.s� <br />