Laserfiche WebLink
Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision wloSurvey: $50.00 <br /> Survey of Existing Parcel: 550.00/lot <br /> an/d,,/oor, Pre-Application Form /��j Subdivision wttSurvev: azoo.00*sso.00not <br /> Owner: 77/2)/2) we&_JZ_ )!}�c v/ii"L� PiN I/i.4✓ : -0 <br /> �f �� A <br /> Address: X636 �DOaII'Cl.� />• ZeA L Address: //ke 2AAc 3 <br /> Phone: 461- 73/'3-739 Phone: /I5 - 3y9-8386 wI <br /> Q 18 3355 yJrdO Original Parcel Information . C7 <br /> Parcel ID#: 64 332!5' 06 0 Section �2` Township 39 Range O <br /> Original Description(or attach copy): AfiT%d7— 3 COM f/ 6f /t;1J <br /> 6 <br /> �tc7ZOr (�y CSm> V6 p /50 61. 3 > <br /> d <br /> Current Zoning: :k `—a Floodplain Y/N: Wetlands Y/N: <br /> Lake/River Classification: Name of Water Body: !'i h-f Lac/Ce D� <br /> Shoreland Agreemt or SIPS Y Farmland PreservationY T: _Managed Forestry Law Y(V_ <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: o? 4e I— C-54,7) <br /> Acres: Z. '7/P <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided yo <br /> (1� <br /> If ves.describe access: <br /> c Signature of Owner: Date: <br /> 00 Signature of Owner: Date: <br /> A <br /> ➢ Does parcel meet Zoning Requirements? <fyy� No <br /> ➢ Does parcel require a Survey? Cies — No s <br /> ➢ Permit application fees submitted? ❑ Amount S D 0' D Receipt# 3�3 <br /> H ❑ Reconciles with Real Property Lister Yes No Date: m _° <br /> a` <br /> If not,explain: <br /> 0 0 <br /> 0 <br /> A¢plicatio pproved / Deniieed� Rei nforDenial: <br /> �� Date: 3��G <br />