Laserfiche WebLink
Fees (must accompany form): <br />Burnett County Subdivision Permit Application Subdivision w/o Survey: 550.00 <br />Survey of Existing Parcel: $50.00/lot <br />and/or Pre -Application Form Subdivision w/ Survev: S200.00 + S50.00/lot <br />Owner: Jah< CdH,•,:ya� <br />Address: 2 tzo q' A,1 -4.l / �D <br />0Qh6t0-y U//J ,S483v <br />Phone: -7 If- 2Sq- 336 o <br />C Z A7fi <br />Address: Z g IfT AI /C�T�� �O <br />1%4tiL, g- y Ifts f'4 93-0 <br />Phone: 9'52-174-1,09Z <br />Original Parcel Information <br />C07-ot $ .. Z• 40 •rt • rq -S �— <br />- <br />007: 01700o It <br />Parcel ID #:- 06-f, 611f 006 - 00"76/99000 Section_14_Township "(0 Range is <br />Original Description (or attach copy):L-' s%14/ Cf A X98 i <br />Lof r /)(Z Cj4, 19/$ <br />Current Zoning: PIR ` Floodplain()N: <br />Wetland6N: Lake/River Class: Z <br />Name of Water Body: SAO f l L r <br />Shoreland Agreement/SIPS Y/N: ? <br />., <br />Farmland Preservation Y( <br />Managed Forestry Law Y11D <br />New Parcel Information <br />Proposed New Legal Description and Parcel Size: <br />_Me I.✓ ci ih 2L f f C" n. r,,r iA e <br />_lo 500 rtve-,, )17t194L &/ <br />Acres: Z.3 <br />(If parcel is to be surveyed, provide preliminary map. <br />See attached for preliminary map requirements.) <br />Proposed access to public road: C6 f,1* 4 <br />Proposed access to public waters to be provided Y/N: {.twihc <br />If yes, describe access: — <br />Signature of Owner: `.-� re <br />-cx'� Date: f <br />Signature of Owner: U, <br />-J Date: 17 <br />Does parcel meet Zoning Requirements? <br />Yes .No 7 , <br />Does parcel require a Survey? <br />Yes No <br />o' <br />Q0 <br />r Permit application fees submitted? ❑ <br />of <br />Amount $ Receipt # <br />r <br />❑ Reconciles with Real Property Lister Yes <br />No Date: <br />d <br />0 <br />a <br />If not, explain: <br />70 <br />A <br />n <br />0 <br />P <br />a <br />Applicatio . Approved Denied Reason for Denial: <br />Land Use: <br />Date: <br />