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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form or Map Review Form Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> Subdivision w/Survey: $200.00+$50.00/lot <br /> Owner: RONALD ALLEN FAYE Buyer: <br /> & Richard Faye <br /> Address: 1731 SKATFR DR Address: <br /> EAGAN MN 55122 z <br /> 0 <br /> G <br /> Phone: 'citc.,--et t0-.it. : b i z -2 z 5 - ie cc ?3 Phone: Qt' <br /> 018332607500 Original Parcel Information <br /> Parcel ID#: 018332607600 Section 26 Township 39 Range 16 a <br /> Original Description(or attach copy): Lots 3 & 4, CSM No. 1329, vol. 6, p. 309-310 <br /> Q <br /> D <br /> �R , N/A <br /> _ <br /> Current Zoning: Floodplain Y/N: Y. Wetlands Y/N: Y Lake/River Class: <br /> .o Name of Water Body: Clam Lake Shoreland Agreement/SIPS Y/N: N <br /> ID <br /> N N <br /> Farmland Preservation Y/N: Managed Forestry Law Y/N: <br /> aa <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: We are submitting a new CSM that <br /> (11 <br /> combines two into 1 lot. <br /> Acres: 1 .77 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Access easement to Pike Bend Road laT <br /> Proposed access to public waters to be provided Y/N: N `, <br /> If yes,describe access: )..' <br /> Signature of Owner: Niro, Date: <br /> P <br /> signature of owner: nate: 2 <br /> 2 <br /> F <br /> ➢ Does parcel meet Zoning Requirements? Yes No #/903 ro <br /> N > Does parcel require a Survey? Yes No <br /> o <br /> 0 <br /> Q <br /> J> Permit application fees submitted? 0 Amount$ . � Receipt# <br /> 4A Reconciles with Real Property Lister es No Date: 8/a4/0/0 <br /> a If not,explain: <br /> a <br /> a. <br /> 7:/ <br /> a <br /> aApplication: pprove / Denied Reason for Denial: <br /> Land Use: Date: <br /> 2, --Lf..71-j).----- 0,,yze2 <br />