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12/11/2020 Image.jpeg <br /> {- Fees(must accompany form): <br /> Burnett County Subdivision Permit Applicati0n Subdivisionw/o Survey: 550.00 <br /> e Survey of Existing Parcel: $50.00/lot <br /> ,a and/or Pre-Application Form Subdivision w/Survey: 5200.00+550.00/lot <br /> 1, <br /> St Midtown LLC-Steve Torbenson <br /> t7wner: Buyer: <br /> Address:3201 Cty Rd 42 Ste 1026. <br /> Address: <br /> � Burnsville MN 55306 .1 <br /> Phone: 512-368-1298 Phone: <br /> Wit; Original Parcel Information C <br /> Parcel fD#: 07-018-2-39-16-26-5 15-093-02$000,027000 Section 26 Township 39N Range 161 <br /> Li". Original Description(or attach copy): Clam Lake Pines E112 Lot 17 & Lot 18 r / <br /> g p <br /> 7 <br /> i 0 <br /> f: <br /> . Current Zoning: RR1 Floodplain YIN: Y Wetlands Y/N: N Lake/River Class: ) <br /> - Name of Water Body: Clam Lake p <br /> Shorefand Agreement/SIPS Y/N: <br /> fri` Farmland Preservation Y/N:N <br /> Nianaged Forestry Law YIN:N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM Ilk <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> r, Proposed access to public road: <br /> C <br /> Proposed access to public waters to b ovi d YIN: m <br /> If yes,describe access: G <br /> Signature of Owner: /7 (/ <br /> i- // <br /> Date: 1" -672-0 <br /> Signature of Owner: Date: <br /> 4 <br /> Does parcel meet Zoning Requirements? Yes No <br /> e. <br /> > Does parcel require a Survey? Yes No ,t <br /> as ' Permit application lees submitted? 0 ,` <br /> _— Amount.� Receipt{/ ' ->.f"" <br /> CC Reconciles with Real Property Lister e <br /> t No Date: 1f< ^yl <br /> c- If not,explain: <br /> m <br /> o <br /> Application: Approti ed I Denied Reason for Denial: Q}, <br /> Land Use: , ,' ., ' Date:------ <br /> 4 <br /> 1!1 <br /> https://mail.google.com/mail/u/2/#inbox/FMfcgxwKjnczxtjBfWDbjbtsZcCkvtsr?projector=1 <br />