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Authentisiyn ID:CFF892S6.92F1.468B-9098-EBD5D3C8aaE2 <br /> Fees(rust accompany form): <br /> Burnett County Subdivision Permit Application Suhdivisionw/o Survey: $50.00 <br /> and/or Pre—Application FormSurvey of Existing Parcel: $50.00/lot <br /> Subdivision w/Survey: 5200.00+$50.00flot <br /> Owner: John &Marilyn Eastep Buyer: <br /> hs <br /> Address:411 E 98th St Apt 207 Address: <br /> Bloomington MN 55420 <br /> :cn <br /> C <br /> Phone: Phone: iij <br /> MIIMIIMINeINEk Original Parcel Information <br /> Parcel ID#: 07-020-2-40-16-11-5 05-001-013000 Section 11 Township ON Range 16W <br /> Original Description(or attach copy): W 100'of E 416 1/2' of Gov Lot 1 a <br /> eD <br /> Current Zoning: RR2 Floodplain Y/N: V Wetlands Y/N: N Lake/River Class: <br /> Name of Water Body: Minnow Lake Shoreland Agreement/SIPS Y/N; <br /> Farmland Preservation YM:N Managed Forestry Law Y/N:N ti <br /> New Parcel Information <br /> I <br /> Proposed New Legal Description and Parcel Size: CSM <br /> • <br /> • <br /> • <br /> Acres: D,24 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> • <br /> Proposed access to public road: <br /> w <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access; �; <br /> Signature of Owner: '�y ch el ao Date: <br /> ,�:�(�:evm EST . <br /> Signature of Owner: el <br /> Date: 0 <br /> _,_:::�:_. _ <br /> D. Does parcel meet Zoning Requirements? Yes No '" - 192_.(74c R <br /> c ➢ Does parcel re1. quire a Survey? Yes No <br /> B, IN <br /> > Permit a <br /> 0 <br /> 9i application es submitted? 0 Amount$ <br /> pp fees r Receipt# .— <br /> _ W <br /> r, 0 Reconciles with Real Property Lister Yes No Date: <br /> P <br /> „S�_ <br /> o., if not,explain: <br /> 00 <br /> n W <br /> o <br /> EL w <br /> ND <br /> Applicat pproved 1 D• ed Reason for Denial: <br /> �� <br /> Land Use; 1111L, _ Date; ‘72,9 00 <br />