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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-A lication Form or MapReview Form Subdivision w/o Survey: $50.00 <br /> pp Survey of Existing Parcel: $50.00/lot <br /> Subdivision w/Survey: $200.00+$50.00/lot <br /> Shawn & Tammy Good <br /> Owner: Buyer: i <br /> Address: 3615 Zinnia Lane N Address: i. <br /> Plymouth MN 55441 <br /> P <br /> C. <br /> Phone: Phone: 'C;5 <br /> Original Parcel Information U <br /> Parcel ID#: 014220401600 Section04 Township 38 Range 15 c' <br /> Parcel described in WarrantyDeed, Document No. <br /> Original Description(or attach copy): <br /> 432352. Metes & Bounds based on Survey D-487. CA <br /> Current Zoning: RR-1 Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: N/A <br /> Name of Water Body: Sand Lake Shoreland Agreement/SIPS Y/N; N <br /> 1\ <br /> a Farmland Preservation Y/N: Managed Forestry Law Y/N: N <br /> a <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: This is a CSM of an existing Lot. <br /> Acres: 0.63 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Easement Road connectingout to STH 70 a <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: N07 <br /> If yes, describe access: b <br /> Signature of Owner: N/A Date: <br /> n <br /> signature of Owner: vale: o <br /> b <br /> F. <br /> ➢ Does parcel meet Zoning Requirements? Yes No G4 /357' ft <br /> at <br /> ➢ Does parcel require a Survey? Yes No ,cr-- 6Aezeize7 -0 <br /> 0 <br /> E. e0 <br /> Pcroermit application fees submitted? ❑ Amount$ SO Receipt# <br /> VA <br /> 0 Reconciles with Real Property Lister Yes No Date: NCI <br /> aIf not,explain: <br /> a <br /> e1> <br /> a <br /> 0 <br /> ca. pproved �enied Reason for Denial: <br /> c. <br /> Land Use: i_ Date: <br /> 614,0C%'2a <br />