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90 <br />Fees (must accompany form): <br />Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br />Survey of Existing Parcel: $50.00/lot <br />and/or Pre -Application Form Subdivision w/ Survev: $200.00+$50.00/lot <br />Owner: Brooks Dennis Letourneau Buyer: <br />Address: 18491 Everett Path Address: <br />Farmington, MN 55024 <br />Phone: <br />Phone: <br />QrilZinal Parcel Information <br />07-012-2-4. C-15-10-5 15-123-033000 <br />07--012-24`--15-10-515.--172804000 <br />4; 1051 -Parcel ID 03000 Section 10 Township 40N Range 15W <br />07-012-2-40-.15-10-5 15-128-036000 <br />Original Description (er attach copy): Deerpath Addition to Voyager Village Lots 23, 24, 25, & 26. <br />Current Zoning: PUD, Floodplain Y/N: Y Wetlands Y/N: N Lake/River Class: <br />Name of Water Body: _ Shoreland Agreement/SIPS Y/N: <br />Farmland Preservatiwi Y/N: Managed Forestry Law Y/N: <br />New Parcel Information <br />Proposed New Legal rescription and Parcel Size: _ <br />New 3 lot CSM corbining Lots 18-20 for William Miller, 21 & 22 for David Engel, <br />& 23-26 for Erooks.'•_etourneau. Acres: <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to pu`.)lic road: <br />Proposed access to public waters to be provided Y/N: <br />If yes, describe access: <br />Signature of Owner: _ <br />- --' - - ----j'?/7e/ <br />Date: -/- --- - <br />Signature of Owner: Bate: <br />Does parcel meet =toning Requirements" Yes No <br />N Rej la-a8-ao1'6 <br />Does parcel requi ; a Survey? Yes [�No C\ Qrt) y� Ip -73(o <br />°Q ➢ Permit application fiees submitted:' ❑ Amount $ � �U Receipt # <br />t, ❑ Reconciles with RuA Property Lister Yes No Datc: <br />s� <br />0 <br />If not, explain: <br />x — <br />0 <br />a — <br />Applicatio Appro,,ed / Denied Reason for Denial:_ <br />Land Use: 9 z4� / Date: — <br />