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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application subdivision wio stavey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survey: $200.00+$50.00/lot <br /> Prior <br /> Owner: Margaret Holt Rev Trust Buyer: Susan Schmitz Revocable Trust d <br /> A <br /> Address: 407 15tt1 Ave SW Address: 4560 Fable Hill Ph= N <br /> z <br /> Rochester. M 55901 Hugo, MN 55038 <br /> 'tA <br /> Phone: Phone: 763-242-490.2 W <br /> Original Parcel Information <br /> 07-032-2-41-16-35-5 05-004-011000 <br /> Parcel ID#: 07-032-2-41-16- 5-B 0&003-02 000 Section 35 Township 41 N Range 16W 0 <br /> Original Description(or attach copy): PCL Gov Lot 4 Desc 592/183 Ex 597/212 (Lot 2 Breezy <br /> Hgts D-476)&Lot 3 CSM V13 P 252(#274201)&Also 597/212 (Gov Lot 3&4) Map#3020 <br /> Easement#409581 <br /> b Current Zoning; RR2 Floodplain Y/N: Y Wetlands Y/N: N Lake/River Class: - <br /> Name of Water Body: Minerva Lake Shoreland Agreement/SIPS Y/N: N <br /> Farmland Preservation WIN:- N Managed Forestry Law Y/N: (ti3 <br /> New Parcel Information G, <br /> Proposed New Legal Description and Parcel Size: CSM to combine 2 existing lots �i1 <br /> Parcel# 07-032-2-41-16-35-5 05-003-025100 <br /> Acres: <br /> 2.97 n <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C <br /> Proposed access to public waters to be provided Y/Nc <br /> If yes,describe access: <br /> , <br /> Signature of Owner. Date: <br /> Signature of Owner: Date: o <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> ➢ Does parcel require a Survey? Yes No <br /> i� <br /> 0° ➢ Permit application fees submitted? ❑ Amount$5b�cb R> t# 00t f V� <br /> t. ❑Reconciles with Real Property Lister Yes No Date: <br /> m <br /> C <br /> c If not,explain: <br /> e9 <br /> n <br /> O <br /> •t <br /> a <br /> Application pproved / enied Reason for Denial: <br /> t <br /> Land Use: 2 y ate: <br /> JAN 1 S 2020 <br /> Burnett County <br /> Land Services Department <br />