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Fees(must accompanc fomU <br /> Burnett County Subdivision Permit Application Subdtcision%% oStinz} 55000 <br /> Suney of Existing Parcel. S50.00lot <br /> and/or Pre-Application Form Snbdi%ision„ Sunz%: S200.00-SS000lot <br /> Owner: jee_ -4- 5QVAf" /f 4 n r_7 Buyer: <br /> Address• ,,Q82c l (ourJ IZd r`" .address: � <br /> Isa r t�1L S"�e30 <br /> Phone: Phone: <br /> Original Parcel Information -1 <br /> Parcel ID#: dj-CG?C�?_ya /4 .��.S 5 (Xr - 0I)tVo Section 35- Township H� Range V <br /> Original Descriptio.. (or attach copy): 40,f 3 LO <br /> I � <br /> Current Zoning:���Floodplain 1"/�: ' Wetlands l"/N: Lake/Riser Class: <br /> 3A <br /> 'w Name of Rater Body: t ' Shoreland Agreement/SIPS I"/N; 77v/ _ <br /> Farmland Preseration l'/V: Managed Forestry Law Y(\: Q <br /> \evv Parcel Information c NO- 3' <br /> Proposed New Legal Description and Parcel Size: 1/fit J d , u CJtt•^ 4 <br /> �i �j L 1 �' - �p na('c.-x JKcJe Ctc f-eS ;ctc h <br /> Acres: / 7, <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> b <br /> Proposed access to public waters to be provided Y/N:� '- <br /> v <br /> If yes,describe access: ` <br /> I <br /> Signature of Owner: Date: <br /> Signature of Owner. _ Date: <br /> j o <br /> c <br /> Does parcel meet Zoning Requirements? 3 es .\o <br /> a <br /> > Does parce!regaire a Sun•er? }'es .\O <br /> _J Permit application fees submitted? ,nrornt$-3-M�r _ <br /> Receipt <br /> O Reconciles with Real Property Lister Yes NO Date: _ <br /> e- [f not,explain: <br /> ll EWE <br /> __- <br /> -- <br /> ApplicationApprov Denied Reason for Denial: <br /> Wertild G erar zo G e_�f W/1-A S — MiN RNETT COUN <br /> Land Use: _ � �RIZ-1—S16,ate: <br />