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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 Subdivision w/Survey: $200.00+$50.00/lot <br /> A) <br /> r <br /> Owner: c c Intl IPA+ % <Li' Li A rl l 1 Buyer: <br /> Address: .3(40 L �r Lc..Ver--0,4( Address: i. <br /> DAnbil;y vk1 I 5 4 8 3c, P <br /> Phone: _ 73 3 - 06 b Phone: <br /> Original Parcel Information <br /> Parcel ID#: ©?"DI a-')."'1O-�S-6t/-S �' Section / Township 4/0 Range f 5 <br /> �/f O <br /> Original Description(or attachicopy): Pa fl' c. ( -v .f 2 EAS 0{ a <br /> 141e Oto( f cti d . C. _ <br /> Current Zoning: �� 2. <br /> �/Floodpl/Ia++in YIN: /1� I Wetlands Y/N: Lake/River Class: -q <br /> la Name of Water Body: ' °f Nq'h I d 4 d 6, Shoreland Agreement/SIPS Y/N: /1° <br /> Farmland Preservation Y/N: /JO Managed Forestry Law Y/N: tit , <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Li- I L y C.SAA • live r C 14.4•Vika'}" <br /> 15•132- cle-tt pa,ce-I Will a + a I\-IU.g o-F S't4 r ey cket...1 neJ� (-e5A ( <br /> d'f Sc f i fr6o-n Acres: Y.56 a C-PC S <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Y0 S C <br /> a <br /> Proposed access to public waters to be provided YIN: Ye S t <br /> If yes,describe accesSi nature of Owner: 0"V� \ , 0Date: �g <br /> Signature of Owner:`. %'►� j <br /> g ,1/42,04,1-1 ._ t'}4'7 Date: ��/S, Z) el <br /> b <br /> > Does parcel meet Zoning Requirements? Yes No i9 <br /> N <br /> D Does parcel require a Survey? Yes No <br /> a' <br /> fQ ➢ Permit application fees submitted? 0 Amount$3c(.. Receipt# 5755- <br /> t" <br /> 7j5r., 0 Reconciles with Real Property Lister Yes No Date: --a <br /> a <br /> CCCOME 1 <br /> °' If not,explain: <br /> n <br /> Jr APR 2 2 2020 J <br /> a <br /> y <br /> Application: , pprove s Denied Reason for Denial: <br /> bumett County <br /> Land Services Department <br /> Land Use/ 9/Z0-0Z-49 Date: <br />