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Fees (must accompany form): <br />Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br />Survey of Existing Parcel: $50.00flot <br />and/or Pre -Application Form Subdivision w/ Survev: 5200.00+550.00/lot <br />Owner: Daniel & Nancy Lee Buyer: Teresa & Todd Sanden F --t — <br />Address: 509 1st St N Address: 1149 Black Oaks Ct <br />Hopkins MN 55343 Anoka, MN 55303 <br />Phanes 952-935-0406 _ Phone: 612-286-1808 <br />Original Parcel Information <br />07-034-2-37-18-21-5 05-004-026100 <br />Parcel ID #: 07-034-2-37-18-21-5 05-004-025100 Section 21 Township 37N Range 18W <br />Original Description (or attach copy): Lots 1 & 2 CSM V25 P285 (GL 4 & 5) (FMRLY PRT V1 P91) <br />Current Zoning: RR2 Floodplain Y/N: Y Wetlands Y/N: N Lake/River Class: - <br />Name of Water Body: Big Trade Lake Shoreland Agreement/SIPS Y/N:' <br />Farmland Preservation YIN: ' Managed Forestry Law Y/N: - <br />New Parcel Information <br />Proposed New Legal Description and Parcel Size: 1 lot CSM combining lots 1 & 2 CSM V25 P285 <br />Acres: 1.21 <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: existing <br />Proposed access to public waters to be provided Y/N: <br />If yes, describe access: <br />Signature of Owner: <br />w(D4� <br />Date: <br />Signature of Owner: A ltt.A, 10 <br />Date: T <br />➢ Does parcel meet Zoning Require ents? Yes <br />No <br />c /2 /8'7z- 7 <br />c <br />➢ Does parcel require a Survey? Yes <br />No <br />° <br />O <br />�i <br />Permit application fees submitted? ❑ Amount $_ <br />Receipt # <br />�., <br />❑ Reconciles with Real Property Lister Yes No <br />Date: <br />c <br />If not, explain: <br />rs <br />0 <br />Q <br />y <br />Applicati . Approved enied Reason for Denial: <br />