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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: Ryan Grendahl `°c <br /> Buyer: A 2 <br /> v v <br /> Address:3432 Wood Duck Dr NW Address: <br /> Prior Lake, MN 55372 ,� c <br /> 00 <br /> Phone: 612-850-5004 Phone: u <br /> N & <br /> C t <br /> Original Parcel Information N a <br /> Tax ID#: 22542, 22543, 22544 Section Township Range VI <br /> Original Description(or attach copy): C <br /> — — —. e <br /> N <br /> Current Zoning: Floodplain Y/N: Wetlands Y/N: Lake/River Class: Ik <br /> I <br /> Name of Water Body: Shoreland Agreement/SIPS YIN: <br /> Farmland Preservation Y/N: Managed Forestry Law Y/N: <br /> S <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: ��o (e,74 GSA <br /> lk <br /> Acres- <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> X <br /> Proposed access to public waters to be provided Y/N: <br /> CI <br /> If yes,describe access: L U i <br /> Signature of Owner: 6D_ 4.4.--- l,/ti Date: / — 1/ . p;L/ <br /> Signature of Owner: Date: I94 <br /> Fee Rec: 1 oc t — <br /> ➢ Does parcel meet Zoning Requirements? Yes 1Vo <br /> Check#: /k 7i <br /> ➢ Does parcel require a Survey? Yes No ° <br /> r <br /> z <br /> z cA <br /> o <br /> Reconciles with Real Property Lister Yes No Date: n j ^ <br /> ni <br /> a ` uuu <br /> If not,explain: ' u co Z <br /> B (� <br /> m `a^. KU <br /> o O 00 <br /> 00 CM <br /> c <br /> Applicatio Approved /)enied Reason for Denial• r7 w q <br /> Land Use: Date: m m t� <br /> o M <br />