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2010-08-16 12:41 Cummins 7635745201 » <br /> ! 7.IS321ZA528 -D 7/2 <br /> Foe$j.. aeaoropmrr sue l: <br /> Burnett County Subdil�iaion Permit Application. Send vW"WM gwyer: moo <br /> and/or Pre-Application Farm SUW s I .Dona <br /> Robert C. & Bonnie G. Robert C. & Kathleen M. <br /> Dwaer Armstrong <br /> Buyer, Hanson <br /> Addrees: 6927 228th Ave.. NE Addraw: 9924 Fremont Ava S <br /> Stacy, MN 55079 Bloomington, MN 55431 <br /> P <br /> W <br /> phorw; 651/675-6704 pyo <br /> QrW%d Parcel intoratatioa W <br /> Parcesoo. 018331602300 Satton 16 YawasUp 39N Rxoge 16W <br /> Orlaml Description(or ottach copy): '. SE 1/4, SW 1/4 r, <br /> t".arrest Zoald#t A2 Ittaodptala YAY: N wvnen&Ym. N Lnkemver Cis", k <br /> 4 <br /> > Name of Water Body: NA 9borelead AgreemendSIPS YfN N ( { <br /> Itaratiand Preservation YAYr N Msnagod ttarmtry law YM: N <br /> Now Pami Gtfort AMM (° <br /> prapaead Naw LtRai DcscripWg aad pareet 8dse:E 1/2,d'1/4 SW 114 3 <br /> nU-DISC-r�/-yam-l(o lion Ib��IrD fll(�m` U <br /> A I � �d� Acres: 20 <br /> (If parcel is to be surveyed,provide VMialaary otap. Bee attached thr prellmtoary map ragvIreaoontx.) <br /> Proposed same to public road: NA <br /> Proposed amm to pabtle waters to be provided YAW N <br /> If yes,describe access, p� <br /> Signature of ow Dais-, <br /> Signature of Owner: Date:_ <br /> 7+ +gwmpe°mcaCmse<ZonheRRerl+rNanfsntx? Yes -- No <br /> D Does pnrrel regwfrs a 5nrvey? Yes Na C <br /> A Perm#i{ppJkntdon feessudar(etadP t3 �fnrorrrr 3 5� 0 ltec:uftrt#.._._ w <br /> W <br /> LI Reconciles with tical Property Lister Yes No Date J <br /> _ o <br /> if not,explain L-2-i <br /> �. UJ <br /> C7 — ------- c <br /> Application: 1 I)eoled -Retm for Deatafi <br /> [sad Dse Irate: �' <br />