2018/11/26 - LAND USE - SUB - Certified Survey Map - SUB-18-77 (2)

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Fees (must accompany form): Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 Survey of Existing Parcel: $50.00/lot and/or Pre -Application Form Subdivision w/ Survev: $200.00 + $50.00/lot Owner. Timothy Muir -are Buyer• Bruce Howe Address: 7229 177th Ave NE Address: 224 Grand Ave Forest Lake MN 55025-8875 New Richmond, WI 54017 Phone: 651-464-4489 Phone: (715)781-2144 Original Parcel Information 07-030-2-38-16-03-5 15-474-016000 Parcel ID #: 07-030-2-38-16-03-5 15-474-015000 Section 03 Township 38 Range 16 Original Description (or attach copy): Second Addition to Mound Beach Lot 11 Block 1 & that part Lot 1 CSM V2 P3 ©esc in 506/38 & Second Addition to Mound Beach Lot 10 Block 1 Current zoning: RR1 Floodplain Y/N:_][Wetlands Y/N: Lake/River Class: Name of Water Body: Clam Lake Shoreland Agreement/SIPS Y/N: Farmland Preservation Yom: Managed Forestry Law Y/N: New Parcel Information Proposed New Legal Description and Parcel Size: New 2 lot CSM shifting 40 feet of shore line (0.059 acres) from Lot 11 to Lot 10 Acres, 2.1 (If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) Proposed access to public road: Proposed access to public waters to be provided Y/N: If yes, describe acce : � �� F �j t ..11.1.. ....r/.a�� Land Use: Date: Signature of Owner: _., .- v Date: l/F_ o b -- - ➢ Does parcel meelIZIoning Requirements? Yes No de"'k e> Does parcel require a Survey? Yes No e °Q / 0i 7 ➢ Permit applicationfees submitted? 0 Amount $ Receipt # r 0 Reconciles with Real Property Lister Yes No Date: m a If not, explain: 7y 0 a y ApplicaYApproved Denied Reason for Denial: Land Use: Date: