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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/oSurvey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision w/Survey: S200.00+$50.00/lot <br /> wner N fD <br /> Owner: Thomas & Ann Sandstrom Trust owon Richard & Darlene Lund ` 3 <br /> v <br /> Address:6968 Dupre Rd Address: 1583 S Bavarian Pass A <br /> Centerville MN 55038 Fridley MN 55432 <br /> N <br /> Phone: Phone: `\ w <br /> z <br /> Original Parcel information U 0 <br /> 1� <br /> Tax ID#: 07-032-2-41-16-35-5 15-351-033000 Section 35 Township 41 N Range 16W <br /> 07-032-2-41-16-35-5 15-351-032000 <br /> Original Description(or attach copy): <br /> Jahnsen's Riverview Park Lot 22&prt of 23 O <br /> 0 <br /> A <br /> z1 -r <br /> Current Zoning: RR3 Floodplain Y/N:Y Wetlands Y/N: N Lake/River Class. <br /> Name of Water Body: Minerva Lake Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N:N Managed Forestry LawYIN: N .�1— <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM <br /> iik <br /> Acres- <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> k <br /> 4 <br /> Proposed access to public road: v., <br /> Proposed access to public waters to be provided Y/N: sc <br /> If yes, describe access: <br /> N)v N <br /> Signature of Owner: -- xY Date: AO/ 3 l4 <br /> Signature of Owner: /:'`�'NC Date: f I 1`i /`'�3 <br /> Fee Rec: ,OO' my <br /> Does parcel meet Zoning Requirements? Yes Na Check#: 40 8'7� <br /> i Does parcel require a Survey? Yes No ed, <br /> i <br /> 75 <br /> H <br /> Reconciles with Real Property Lister tilip No Date: 10/73/20z3 75 <br /> c M <br /> If not,explain: E <br /> 0 <br /> Applicatio(Approved / enied Reason for Denial. <br /> Land Us - Date: <br /> ___...4.-----_____ /0 ii/e0,3 . <br /> g <br />