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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 /> 1.0 <br /> ep <br /> owner: Melvin &Allyson Medin Buyer Voyager Village POA <br /> Address:4513 Silver Birch Trailwa y 28851 Kiikare Rd z <br /> Address: F'o 0 <br /> Webster Wi 54893 Danbury WI 54830 <br /> Phone: Phone: <br /> Orising'Parcel Information <br /> Tax ID#: 07-012-2-40-15-22-5 15-707-090000, Section 22 Township 40N gang 15W <br /> 091000&092000 <br /> Original Description(or attach copy): Lots 85-86 &OL 1 Silver Birch Add to VV <br /> is <br /> Current Zoning: PUD Floodplain Y/N:N Wetlands Y/N: N Lake/River Class: <br /> NIA. <br /> Name of Water Body Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N:N Managed Forestry Law YIN: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM <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 /> E <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: <br /> Signature of Owner \ Date: <br /> U iittL fri " 'tL LL&ov B. ‘t4. 2L{ <br /> Signature of Owner: Date: <br /> Fee Rec: <br /> > Does parcel meet Zoning Requirements? Yes Noci Check#: <br /> > Does parcel require a Survey? Yes No <br /> ry <br /> co <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> 0 <br /> z <br /> Application: Approved / Denied Reason for Denial. <br /> Land Use; Date: <br /> Vl <br />