2018/03/14 - LAND USE - SUB - Subdivision - SUB-17-03

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im b M a� Fees (must accompany form): Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 Survey of Existing Parcel: $50.00/lot and/or Pre -Application Form or Map Review Form Subdivision w/ Survev: S200.00 + S50.00/lot Owner: Donald & Barbara Nelson Address: 14716 Bistram Road Phone: Buver: Lana M. & Thomas M. Schuette Address: 811 County Road F W Shoreview, MN 55126 Original Parcel Information Parcel ID #: 07-040-2-39-19-29-4 03-000-011000 Section 29 Township 39 Range 19 Original Description (or attach copy): The SW SE, Section 29, Township 39 North, Range 19 West, Rxcent the West 3001 of the South 716' and except Me North 14 North 14, T -own of West A4grshiand, Bul nett evanty, Wt. Current Zoning: Floodplain Y/N: N/A Wetlands Y/N: N/A Lake/River Class: N/A Name of Water Body: N/A Shoreland Agreement/SIPS Yom• lY/A Farmland Preservation Y/N: Managed Forestry Law Y/N: New Parcel Information Proposed New Legal Description and Parcel Size: The North 680' of SW SE, Section 29, Township 39 North 19 West, except for the North '/ of the said SW SE and also except the South 86' of the West 300' of the said SW SE, Town of West Marshland, Burnett County, WI. Acres: 10 (If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) Proposed access to public road: Paint Mine Road Proposed access to public waters to be provided Y/N: N/A If yes, describe access: Signature of Owner: Signature of Owner: ➢ Does parcel meet Zoning Requirements? ➢ Does parcel require a Survey? i Permit application fees submitted? ❑ ❑ Reconciles with Real Property Lister If not, explain: Date: 1 -Al-;L Date: 11- - -Z ;z — Yes No Yes Amount $ Receipt # No Date: Application:prove / Denied Reason for Denial: Land Use: QN y t Date: /