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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+$50.00/lot <br /> Owner: Thomas Heenan Buyer: <br /> CD <br /> Address:3457 Kilkare Ct Address: <br /> Danbury WI 54830 <br /> Phone: Phone: <br /> Original Parcel Information <br /> 07-012-2-40-15-13-5 15-124-091000,07-012-2-40-15-13-5 15-124-090000 <br /> Parcel ID#: Section 13 Township 40N Range 15W <br /> Original Description(or attach copy): Deer Lodge Add to Voyager Village Lots 82 & 83 <br /> cJ <br /> Current Zoning: PUD Floodplain Y/N: Y Wetlands YIN: N Lake/River Class: 3 <br /> Name of Water Body: N/A Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation YIN: N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM combine 2 existing parcels <br /> Acres: 1.12 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C7 <br /> a <br /> Proposed access to public waters to be provided Y/N: •� <br /> If yes,describe access: <br /> Signature of Owner: <br /> Signature of Owner: Date: <br /> • <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> -g <br /> ➢ Does parcel require a Survey? Yes No <br /> °A ➢ Permit application fees submitted? 0 Amount$ Receipt it <br /> ® Reconciles with Real Property Lister 46a1 No Date: 1O-5-2 <br /> a <br /> If not,explain: <br /> e <br /> o „*t <br /> 52; ****0 <br /> Application: • pprov•. •enied Reason for Denial: <br /> Land Use: =_mit Date: l0 7z0?..9 <br />