Laserfiche WebLink
Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision w/Survey: $200.00+$50.00/lot <br /> Owner: /14Z- // '7f I— Buyer: <br /> G 33 <br /> Address: L I Address: <br /> A,,,Irr 1 Luz_ ,oc( <br /> Phone: Phone: <br /> Original Parcel Information 4ti <br /> Parcel ID#: Section 2 q 3 Township 3 / Range 1$ <br /> Original Description (or attach copy): <br /> al <br /> Current Zoning: U1/1—„ Floodplain Y/N: /V Wetlands Y/N: Lake/River Class: <br /> Name of Water Body: N/e- Shoreland Agreement/SIPS Y/N: /t/ <br /> 7-7 Farmland Preservation Y/N: Managed Forestry Law Y/N: <br /> a <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) C7 <br /> � <br /> Proposed access to public road: V lc F v y G`l— <br /> Proposed access to public waters to be provided Y/N: <br /> If yes, describe access: N <br /> Signature of Owner: Date: <br /> Signature of Owner: Date: CN <br /> D Does parcel meet Zoning Requirements? Yes No G/e- l/D l t <br /> c > Does parcel require a Survey? Yes No <br /> et) <br /> CfQ <br /> Permit application fees submitted? 0 Amount$ Receipt# <br /> 0 Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> a <br /> 7Fj <br /> °• Applicatio • • pprove. nied Reason for Denial: <br /> Land Use: Date: <br /> / I l <br />