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1-ecsimust acnnulmm tom): <br /> Burnett County Subdivision Permit Application Surit'ision 5arccy 50.00 <br /> Sarrvev of l-'.i61nw kneel. C50.00let <br /> and/or Pre-Application Form subdi inion„' snnev S100.0t, S50001"t <br /> Owner: Ckyr 1, MILL- & Buyer: M <br /> -� r <br /> Address: 6 3S 2 /J*A-7-Y 1677V OAL_. Address: s <br /> Sun-PRISE .{-t- lip <br /> ? <br /> Phone: �3- �S9--LF-s- Phone: �J <br /> Oritinal Parcel Information <br /> -3 o2 'os0-o l l osao <br /> Parcel ID @: -O I Z 000 Section 3 e Township 3B Range 1 , <br /> O <br /> Original Description(or attach coP5 l: 3 w.+ s - LL/I/ 5 kALv,ryMO <br /> bera fie_ - 4 z 69,31 tz�cw* Lkoe—_40, 3,4- 3 // 9�_ ) <br /> r� <br /> Current Zoning: ,4 Z Floodplain Y?i4:�Wetlands Y/Y: Y Lake/River Class: 3 ('1F <br /> Name of Water Body: 1.1 nl-A1A4la1!, Shoreland AgreementISIPS YIN: <br /> Farmland Prescn ation YIN: Managed Forestry Law YIN: <br /> New Parcel Information V <br /> Proposed New Legal Description and Parcel Size:C,e m&rA i.tir /^rm A4jw uJ CSN <br /> i,erf Jl�et✓ Ger! alLL /./eT /h/G�"AIE- <br /> ArG/tlGet+3�� <br /> w <br /> re�: w <br /> (if parcel is to he sun-eyed,protide preliminary map, See attached for preliminary map requirements.) <br /> Proposed access to public road: CX/S Ti64 Ane K.5 r-o- Olp W O <br /> n <br /> Proposed access to public waters to be provided YIN:- rr n <br /> " 1 <br /> If yes,describe access: <br /> Signature of Owner: Date <br /> a gIV19124 as/G <br /> Signature of Owner: Date: A <br /> 3 <br /> c <br /> i l�oes/xur.el nrrrl Znniag lteyrrimrar+rts? }es <br /> a <br /> a <br /> Docs pmtrl require n.Svn'ey� l e� :,, <br /> 0 <br /> Permit oppltc,ttiun jets snbminrd? R .111101ml S ii<crit+r- <br /> r ❑Reconciles with Real Property Lister Yes No Date:_.______—___ <br /> tt <br /> e <br /> If not,explain: -----__--- <br /> .�c <br /> G <br /> .Applicat Appro ! Denied Reason for Denial <br /> Land Use: ate. <br /> p ECHVE <br /> APR 12 2016 <br /> BURNETT COUNTY <br /> ZONING <br />