Laserfiche WebLink
W <br />Fees (must accompany form): <br />Burnett County Subdivision Permit Application Subdivision svtoSurvey: $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: Buyer: <br />Address:_ 1� (� �t �� �� �� ��-'� Address: <br />C <br />Phone: 1 I S Phone: <br />'d41V-�_ 4�' �'f ' i ss c"._ �l, ii JJ <br />6 �I C�-�- <br />tit s-- La 774 <br />-j r t� Original Parcel Information <br />f, <br />Parcel ID #: `� ` °��S L`) Section :.J �( Township 'zk N Range <br />Original Description (or attach copy): _ £}i .� 9 6 CAL 3 <br />Q_ ' fP,'I <br />Current Zoning: s Floodplain Y�_Wetlands Y, N1 Lake/River Class: <br />Name of Water Body: i �JC�E �-�-� Shoreland Agreement/SIPS YIN: <br />Farmland Preservation A/:__ Managed Forestry Law Y(Q <br />New Parcel Infoormation <br />Proposed New Legal Description and Parcel SizeC! S sp <br />} r <br />,r l t,j o_c' I ct' �- � O-U) Acres: L0� <br />(If parcel is to be surveyed, provide.preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: --� V1� �Ls t✓ i�l 1 1 S �' �- U�- <br />Proposed access to public waters to be provided Y <br />If yes, describe access: <br />Signature of Owner: (.t_/,e�Y� iC�1� Date: CIS / l 0 <br />Signature of Owner: Date: <br />➢ Does parcel meet Zoning Requirements? Yes No <br />N <br />o ➢ Does parcel require a Survey? Yes No <br />Permit application fees submitted? ❑ Amount k') Receipt # <br />t, '13 Reconciles with Real Property Lister Yes No Date: <br />n� <br />0 <br />7d <br />If not, explain: <br />0 <br />K <br />a <br />y <br />Applicatio �ovedenied Reason for Denial: <br />Land Use: Date: 4 o <br />n <br />0 <br />C <br />K <br />F <br />