Laserfiche WebLink
Im <br />Burnett County Subdivision Permit Application <br />Fees (must accompany form): <br />and/or Pre -Application Form or Ma Review Form <br />PP P <br />Subdivision w/o survey: $50.00 <br />Survey of Existing Parcel: $50.00/lot <br />Subdivision w/ Survev: 5200.00 + $50.00/lot <br />Joe Gerard <br />Owner: <br />Buyer: Robert Forsha <br />Address: 923 Cloverleaf Circle Address: 4129 Countryview Dr. <br />Hudson, WI 54016 Eagan, MN 55123 <br />715-690-9598 <br />Phone: <br />Phone: <br />Original Parcel Information <br />Parcel ID #: 030232104200&030232101800 Section 21 Township 38 Range 16 <br />Original Description (or attach copy): Gov. Lot 6 and parcel in Gov. Lot 5 described in <br />Warranty Deed, V.605, p.302 (attached), which is also Parcel 1 of survey <br />filed as D-380. <br />RR -3 _ N/A <br />Current Zoning: & RR -1 Floodplain Y/N: Y Wetlands Y/N: Y Lake/River Class: <br />Name of Water Body: Long Lake Shoreland Agreement/SIPS Y/N: N <br />Farmland Preservation Y/N. N <br />Managed Forestry Law Y/N: <br />N <br />New Parcel Information <br />Proposed New Legal Description and Parcel Size: We are submitting a new CSM that <br />creates a new 10.49 acre parcel in GL6 and merges a new parcel in GL6 with <br />the Forsha lot in GL5 plus Outlot in GL5 due to road. Acres: <br />12.59± <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: Direct access to S. Long Lake Road + 40' easement <br />for Lot 2 <br />Proposed access to public waters to be provided Y/N: N <br />If yes, describe access: <br />Signature of Owner: N/A <br />signature of owner: <br />Date: <br />mate: <br />➢ Does parcel meet Zoning Requirements? Yes No Arc 3/9 ny <br />➢ Does parcel require a Survey? Yes No <br />)' Permit application fees submitted? ❑ Amount $ 7-5-0,� <br />O. -O Receipt # <br />❑ Reconciles with Real Property Lister Yes No Date: <br />If not, explain: <br />Applicatiop: Approved / Denied Reason for Denial: <br />Land Use: Date: <br />� 1 <br />P <br />N <br />9 <br />