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Fees (must accompany foriny <br />Burnett County Subdivision Permit Application Subdivision w;o Survey: 550.00 <br />Survev of Existing Parcel: S50.001ot <br />and/or Pre -Application Form Subdivision w% Sun ev: S?00.00 - S50.001loi <br />Owner Lot 9 & east half of Lot 10 (Proposed Lot 1) <br />O.vner: Richard and Jennifer Schmict Buyer: <br />Address: 792 Woodduck Drive Address: <br />Woodbury, NDN 55125 <br />Phone: ( 651 1. 751—_3907 <br />Phone: <br />Original Parcel Information <br />C7-038-2-41-14-17-5 15-805-021001 <br />Parcel ID #: 07-038-2-41-14-17-5 15--805-023001 Section 17 <br />Township 41 Range 14 <br />Original Description (or attach copy): <br />Lots 9, 10 cnc 11, Block 3, Tcwn of Webb Lake Assessor's <br />Plot <br />Current Zoning: RR1 Floodplain Y/N: <br />Wetlands Y/N: <br />Lake/River Classification: Name of Water Body: <br />Webb Lake <br />Shoreland Agreemt or SIPS Y/N: Farmland Preservation Y/N: <br />Managed Forestn Law Y/N: <br />New Parcel Information <br />Proposed New Legal Description and Parcel Size: <br />Proposed CSM <br />Acres: 4.26 <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: W Webb Lake Drive via Rainbow Drive (a private road) <br />Proposed access to public waters to be provided Y/N: N <br />If ves, describe access: <br />Signature of Owner: <br />,u, & ty, _SC 41 Nil 1 <br />Signature of Owner: <br />Date:, <br />1 <br />Date: _ IL12- y % 17 <br />Does parcel meet Zoning Requirements? Yes Vo <br />�t <br />Does parcel require a Sur vet,:' Yes :Vo <br />Permit application fees sirlmutteci? ❑ tlnrount S Receipt 4 <br />❑ Reconciles with Real Property Lister Yes No Date: <br />If not, explain: <br />Application <br />Land <br />Denied Reason for Denial: <br />Z©/ �_ Date: <br />C <br />n <br />