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i <br /> 'CONDITIONAL USE PERMIT (CUP) APPLICATION— Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE#: CUP-21-03 ZONING DISTRICT: K - 3 <br /> PARCEL# (24 digits): 0-1 - 02-6--`a - 140 - 14 -3 4- -3 -01- - voD- 0 13 o 0 v <br /> REGTTe 0' '. <br /> TAX ID #: I e8d� E IJ V <br /> i , JAN; 26 6 2021 <br /> Burnett County <br /> Land Services Department <br /> LAND SERVICES STAFF ONLY ABOVE THIS LINE <br /> Applicant Complete All Sections Below This Line <br /> Property Owner's Name: TR-11/4A- 1vr-3 Lo 5 13ot -13 <br /> Applicant's Name: Q gt-65 3D,,,:i ` <br /> Applicant's Mailing Address: a I(o S Du 615 R-049 ,A)E 6s! ( 5'7 Z"j 3 <br /> City State Zip <br /> Applicant's Telephone Number: 1 15- 4.36-- 2_G G ( <br /> Applicant's Email: C 1 tC-K lain 6 6 0 y 4.0 'Corel <br /> If staff has a question about this application,how do you prefer to be contacted? Check one below: <br /> 0 Letter 'hone 0 Email <br /> s/ AILS & GAG/ $VZ $/z Ai tiW-s& <br /> Legal Description: Z.. Z <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: 3y Town#: / O N Range#: 4/ W Town of: C.--49 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Parcel#(24 digits): O`7— 62-1 " 2'1`1 d -14 ^3 4- 3 -62- -04)0 - D 13400 <br /> Tax ID#(1-5 digits): (e e .04 <br /> Lot Area: ft' and a 41'Z- X15 acres <br /> Property Site Address#: IA'£139fY-7(-/k)i 5-ii c '7 3 <br /> Anticipated Start Date: 5 "2-02_1 <br /> Section#of the Ordinance this CUP is referencing: 30'' 8'5 ✓ -1-- 30- 815-(i) <br /> Page 1 of 4 <br /> Burnett County,WI Conditional Use Permit(CUP) Application-Rev 12/2020 <br />