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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: Timothy Kretzmann Trust Buyer: Washburn Family Revocable Trust eq. 3 <br /> C = <br /> Address:3301 46th Ave S Address: 10003 Olinger Rd o <br /> Minneapolis MN 55406 Webster WI 54893 — co <br /> I to <br /> [J <br /> Phone: Phone: N. "' <br /> Original Parcel Information ` &'` <br /> Tax ID 4: 5632 &5633 Section 25 Township 40 Range 15 \ <br /> O <br /> Original Description(or attach copy): GL 1 & Lot 1 & OL 2 CSM V7 P229 g <br /> g CD <br /> F. <br /> 3• <br /> Current Zoning: RR1 Floodplain Y/N:Y Wetlands Y/N: N Lake/River Class- <br /> � <br /> Name of Water Body: North Sand & Pine Lake Shoreland Agreement/SIPS Y/N: s <br /> -11 <br /> v <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> 4. <br /> New Parcel Information �� <br /> Proposed New Legal Description and Parcel Size: 2 lot CSM <br /> ®_; <br /> IA <br /> oil <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Propose access to public road: C <br /> Propose access to public waters to be provided Y/N: <br /> ti.:1- <br /> If yes,d scribe access: <br /> !ar �sh um Nov 7,202519:14:51 CST) A*: 07/11/2025 <br /> u T Date <br /> Fee Rec:/c .��b <br /> ➢—Does parcel meet Zoning-Requirements? Yes -- No — — Check#:G/Z9 <br /> ➢ Does parcel require a Survey? Yes No <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,a iL <br /> plain: <br /> Applicatio Z pproved %•nied Reason for Denial. <br /> Land Use: , Date: <br />