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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> and/or Pre-A lication Form Survey of Existing Parcel: $50.00/lot <br /> PP Subdivision w/Survey. $200.00+$50.00/lot <br /> Owner: Matthew Kabus Buyer: <br /> b <br /> Address:8323 Laddie Rd NE Address: <br /> Spring Lake Park MN 55432 <br /> 0 <br /> Phone: 612-325-5417 C. <br /> Phone: m <br /> t <br /> Original Parcel Information <br /> 07-012-2-40-15-10-5 15-128-094000,07-012-2-40-15-10-5 15-128-093000 <br /> Parcel ID#: Section 10 Township 40N Range 15W 04 <br /> Original Description(or attach copy): Lots 84 & 85 Deerpath Add to W <br /> a <br /> es <br /> 3 <br /> bCurrent Zoning: PUD Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: <br /> a Name of Water Body: N/A• Shoreland Agreement/SIPS YIN: <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N:N <br /> r. <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM combine 2 existing parcels <br /> Acres: I -° <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: d <br /> a <br /> Proposed access to public waters to be provided Y/N: f° <br /> If yes,describe access: 1.1 <br /> Signature of Owner:`-tel Date: 740--g0 <br /> Signature of Owner: Date: a <br /> 6 <br /> D Does parcel meet Zoning Requirements? Yes No I a <br /> N �/'� �� eD <br /> a > Does parcel require a Survey? Yes No <br /> S.as p� <br /> Permit application fees submitted? 0 Amount$ • Receipt# <br /> V <br /> d Reconciles with Real Property Lister 0 No Date: (plagiao <br /> a <br /> If not,explain: <br /> n <br /> a --.1 <br /> C. NI <br /> NI <br /> Applicatiprovedj)enied Reason for Denial: <br /> �� c <br /> Land Use: ,0. I Date: ©ZD 0,2 <br />