Laserfiche WebLink
Burnett County Subdivision Permit Application <br />and/or Pre -Application Form <br />Owner: !�f /l2V F-/,(3 S Buyer: <br />Address: /9loto /J~S!- Address <br />J �_-Rm zkee A4' 5091,6 <br />Fees (must accompany form): <br />Subdivision w/o Survcy: $50.00 <br />Survey of Existing Parcel: $5o.00/lot <br />Subdivision w/ Survcv: $200.00+S50.00/lot <br />Land Use: Date: <br />VO <br />Phone: Phone: <br />Original Parcel information <br />Parcel M #: 279,lo Section Township I <br />Range f 9 <br />Original Description (or attach copy): <br />AllJ % z,,, M )—,:5< C, Tr 11iS -' I& e. &1 , . 3 <br />Z 9$ <br />,�,vD 6'X�rPT'�OG MO yy 6 32� <br />nn <br />Ct irrent Zoning: % 3 Floodplain Y/N: N, Y/N: AZ Lake/River Class: N '9 <br />----Wctlands <br />aN;.sae <br />of Water Body Slroreland Agreement/SIl't; Y/N; <br />R <br />, / <br />l-% rmlaud Preservation Y/N: N __Managed Forestry Law WIN: <br />New Pa.-r_cl Information <br />Proposed New Legal Description and Parcel Size: iZoDS X 2.6 R.aDS <br />".5�50 Fay z <br />ui9� <br />—T.4. <br />= 7 J!e aG�dre(- � �o >�vri� 9 P • Acres: d. <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: y yl vLo j �t. It%P%SOLS <br />12 <br />Proposed access to public waters to be provided Y/N: N <br />If yes, describe access: "�--- <br />Signature oforvuee / 1, Date: _ <br />C/ <br />7—V <br />Signature of Owner: _ Date: <br />Does parcel meet Zoning Requirements? 1 es No R e /Z�II <br />) 7 , f <br />N <br />a <br />r Does parcel require a Survey? Yes No <br />i=• <br />D <br />Permit applicalion fees submilled? ❑ Amount $ �r0i Receipt # <br />— <br />t , <br />\E1 Reconciles with Real Property Lister Yes No Datc: I - 1-7 <br />a <br />a' <br />If not, explain:_ <br />O <br />`t <br />� <br />— <br />a. <br />V1 <br />Applicatioi, Approeed Denied Reason for denial: <br />Land Use: Date: <br />VO <br />