Laserfiche WebLink
'95z f*5.0 A-f pe7z- <br /> Fees(must accompany form): <br /> Burnett County Subdivision Permit Application sumvision wo survey: s5o.00 <br /> Survey of Existing Parcel: $50.00Aot <br /> and/or Pre-Application Form Subdivision%v/Survev- $200.00+$50.0011ot <br /> Owner. t4al L T C44-6jL;Ll✓ 14i4ppemr Bayer: m <br /> '0 <br /> Address: Z4$Z2- 6• CONf-JcPt L k-f, /z.o;}b Address: 9 <br /> w�eSrGa., w1 54Et93 z <br /> 0 <br /> Phone: 12--.? lb- Z 12 o Phone: <br /> Original Parcel Information 61 <br /> Of-oW -Z.4c_q,-;3w 5 06-cn4--014wi) ---3 <br /> Parcel[D#: 07,6,2c- -2-4%, i b•36-3 05-oo4--ot 7✓cPSectioa 3k Township 4,; Range 14, <br /> Original Description(or attach copy): t.Ofi 3 i 4, or &jiM V, Pl 3c <br /> z <br /> 7S <br /> V Current Zoning: F-RR L Floodplain Y/N: N Wetlands Y/N: rJ Lake/River Class: 3 <br /> •e <br /> R, <br /> Name of Water Body: "It.Mo" LAkG Shoreland Agreement/SIPS Y/NL IJ <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: fJ <br /> New Parcel Information('S(y��; � , '-Z <br /> Proposed New Legal Description and Parcel Size: Wevu Z sof Gin/l f4.;ot.1 t=,L�tAt4J t=fwM <br /> Gkt5riQ!l Z Lir CSm) Uw1G C4MMNJ '7b L.T5 3t4 ;QTt4ir- D N4•4't <br /> 1_vr cx,yr. MF-Q <br /> 3 •my a4fs <br /> CAI c45r Ecttd.,!?4V-Y - 1.-hut;sll+�it€ i-ao\IrRtt� ro fLc'�-AMni Acres:_ _9- cc,,4-B 0.57L <br /> i•'}nyG <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 8• LoNs1eR( (AkZ /toAp C <br /> m <br /> Proposed access to public waters to be provided Y/N: t4 f0 <br /> If yes,describe access: <br /> Signature of Owner. ear�od7 , Date: <br /> Signature of Owner: Date: <br /> 3 <br /> e <br /> ➢ Does parcel meet Zoning Requirements? Yes No g <br /> c ➢ Does parcel require a Survey? Yes No <br /> `o• <br /> 00 ➢ Permit application fees submitted? Amount S jMg Receipt# <br /> ❑ Reconciles with Real Property Lister Yes No Date: <br /> e <br /> If not,explain: <br /> 7y <br /> m <br /> n <br /> 0 <br /> 3. <br /> Applicata Approved / Denied Reason for pDe�nial: <br /> VgV10' tic'e-- o4A-1s-oz <br /> Land Use Date: <br /> OCT 18 2016 <br /> BURNETT COUNTY <br />