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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision wio Survey: $50.00 <br /> Survey of Existing Parcel. $.50.00/lot <br /> and/or Pre-Application Form Subdivision wf Survey: $200.00 $50.00/lot <br /> Dale Edlund <br /> Owner: Buyer: <br /> fa <br /> Address:139 Woodridge Ln <br /> Address: <br /> Lino Lakes MN 55014 <br /> c.4 <br /> Phone: 612-812-7530 Cce_Lt..) Phone: (0.f/ OT 64-34, (i4-0He) <br /> Original Parcel Information <br /> 07-020-2-40-16-19-5 15-360-091000 07-020-2-40-16-19-5 15-360-092000 <br /> Parcel ID it: Section 19 Tewn,-hip 40N Range 16W <br /> Original Description(or attach <br /> Jensen's Lakeshore Div of Yellow Lake Lot 32 & 33 Blk 10 <br /> -copy): <br /> Current Zoning: RRI Floodplain Y/N: Y Wetlands Y/N: Lake/River Class: çç <br /> Z' Name of Water Body: Yellow Lake Shoreland Agreement/SIPS YIN: <br /> Fat odand Preservation YIN;N Man-aged Forestry Law Y/N:N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM to combine 2 existing lots <br /> Acres:0-65 <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 Y/N: <br /> If yes,describe access: <br /> Signature of Owner: Cd2 f Date: ..3/3/7120 <br /> Signature of Owner: Da te: <br /> 3 <br /> Does parcel meet Zoning Requirements? Yes No 62/7 <br /> Does parcel require a Survey? Yes No <br /> t,c) <br /> , <br /> Permit application fees submitted? 0 Amount S .57& 7 Receipt it <br /> 0 Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> 7:1 <br /> 3 <br /> Applicatio Approv Denied Reason for Denial: <br /> ZO/0Land Ilse: - Date: <br />