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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: S50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survey: $200.00 S50.00ilot <br /> Owner: Voyager Village POA Buyer: <br /> Address: 28851 Kilkare Rd Address: � <br /> z <br /> Danbu5v. Wl 54830 0 <br /> Phone: 715-259-3910 Phone: <br /> • <br /> Original Parcel information <br /> 07-038-2-41-14-30-5 15-101-011000 <br /> Parcel ID#: through 07-038-2 41-14-30-5 15-101-028000 Section 30 Township 41 N Range 14W <br /> Original Description(or attach copy): Crystal Shores Add to Voyager Village Lots 1-18 <br /> L <br /> Current Zoning. PUD Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: <br /> Name of Water Body:` Shoreland Agreement/SIPS Y/N. <br /> :+ C <br /> Farmland Preservation YRN: Managed Forestry Law Y/N: N <br /> Nov Parcel Information <br /> Proposed New Legal Description and Parcel Size: <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 /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: <br /> Signature of Owner: Date: <br /> Signature of Owner:�r`') f� <br /> na�larr._. 3 -1.� t' Date: 19 0 <br /> G c <br /> Does parcel meet Zoning Requirements. Yes No <br /> N 1 <br /> > Does parcel require a Survey? Yes No <br /> aa. ®fJ <br /> Permit application fees submitted? ❑ Amount S r097 Receipt# 00 �- <br /> �. ❑Reconciles with Real Property Lister Yes No <br /> 1�5 <br /> � If not,explain: <br /> z <br /> m <br /> 0 <br /> c <br /> Applicatio Approve Denied Reason for Denial, <br /> Land Use: V Dated <br />