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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: 550.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survey: 5200.00+S50.00lht <br /> Owner: Voyager Village POA Buyer: b <br /> Address:28851 Kilkare Rd Address: 2 <br /> Danbury WI 54830 z <br /> A <br /> Phone: Phone: a <br /> Original Parcel Information 1 <br /> Parcel ID#' 07-03&2-411.4-31-515-105-015000A<010000 , g 14W <br /> Sectlola-31 Ttlivndliiip •*1NRange oV1 <br /> original Description(or attach copy): c.rrstal VOIleY Add to Voyager Village Lot 5 & 6 <br /> eC <br /> -a Current Zoning: PUD Floodplain Y/N: apt Wetlands Y/N: N Lake/River Class:, <br /> I Name of Water Body: N ,Shoreland Agreement/SIPS YIN; < <br /> Farmland Preservation YIN:N Managed Forestry Law Y/N:N <br /> New Parcel Information °N <br /> Proposed New Legal Description and Parcel Size:.CSM to combine 2 lots <br /> g <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C <br /> t <br /> Proposed access to public waters to be provided YIN: '9 <br /> If yes,describe access: , <br /> Signature of Owner: �vAr or,i .►.►... . 1 , <br /> V��: Date: L. —o`l-2 <br /> Signature of Owner: Date: 3 <br /> i Does parcel meet Zoning Requirements? Yes No de---90- 6 O( z 5 <br /> Ig> Does parcel require a Survey? Yes No <br /> 0/ <br /> °Q > Permit application fees submitted? 0 Amount$ '' ` Receipt#, J a J ty , <br /> J <br /> m 0 Reconciles with Real Property Lister Yes No Date: `J w W 4 <br /> If not,explain:. �a ' U <br /> N <br /> o v 1 �/ <br /> W O `'"C <br /> Applicatio : Approves I enied Reason for Denial: ----- _ -aq 1/4, ---__- <br /> �t <br /> Land Use:_ >>/- �Z( Date: <br /> JJ <br />