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LSubdivision <br />must accompany form): <br />Burnett County Subdivision Permit Applicationw/oSurvey: $50.00 <br />y of Existing Parcel: $50.00/tot <br />and/or Pre -Application Form vision w/ Survev: S200-00+550.00/lot <br />Owner: Daniel & Nancy Lee Buyer: Teresa & Todd Sanden <br />Address: 509 1st St N Address: 1149 Black Oaks Ct <br />Hopkins MN 55343 Anoka, MN 55303 <br />Phone: 952-935-0406 Phone: 612-286-1808 <br />Orizinal 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 Township37N Range 18W <br />Original Description (or attach copy): Lots 1 & 2_QSM V25 P285 (GL 4 & 5) (FMRLY PRT V1 P91) <br />Current Zoning: RR2 Floodplain YIN: Y Wetlands YIN: N Lake/River Class: - <br />Name of Water Body: Big Trade Lake Shoreland Agreement/SIPS YIN: - <br />Farmland Preservation YIN: - <br />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 />Signature of Owner: <br />Y Does parcel meet Zoning Requirements? Yes <br />➢ Does parcel require a Survey? Yes <br />)�' Permit application fees submitted? ❑ Amount $ <br />Date:( <br />Date: <br />No c e /F7L 7 <br />No <br />�O <br />Receipt # <br />❑ Reconciles with Real Property Lister Yes No Date: <br />If not, explain: <br />Applicati Approved enied Reason for Denial: <br />71 o <br />