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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: S50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision w/Survey: S200.00+S50.00/lotCA <br /> co <br /> Buyer: <br /> owner: Jeffrey & Susan Larson <br /> Address:3569 Widgeon Way Address: A <br /> Eagan MN 55123 , c <br /> Phone: Phone: <br /> P <br /> Original Parcel Information G co <br /> Tax ID#:07-028-2-40-14-25-5 05-002-023000 Section 25 Township 40N Range 14W W <br /> 07-028-2-40-14-25-5 05-002-024000 <br /> Original Description(or attach copy): GL 2 <br /> O <br /> ro <br /> Current Zoning: RR1 Floodplain YIN:Y Wetlands Y/N:Y Lake/River Class• <br /> Name of Water Body:Big McKenzie Lake Shoreland Agreement/SIPS YIN: <br /> Farmland Preservation YIN:N Managed Forestry Law YIN: N ,. <br /> New Parcel Information Z111 <br /> Proposed New Legal Description and Parcel Size: CSM changing lot lines on 2 existing parcels <br /> Acres:2.18 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided YIN: <br /> If yes,describe access: GO k(30 <br /> uJJ J, NI <br /> l//a_ <br /> Fee Rec: /OD.�` 42 <br /> > Does parcel meet Zoning Requirements? Yes No Check#: (�Qeb p <br /> Does parcel require a Survey? Yes No <br /> Reconciles with Real Property Lister Yes No Date: /V/?/2152, <br /> If not,explain: <br /> Apphcatio Approved /denied Reason for Denial; <br /> Land � Date: <br /> /' Z7zoa3 <br /> 9 <br />