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CONDITIONAL USE PERMIT (CUP) APPLICATION— Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-15-3�_ ZONING DISTRICT: — <br /> PARCEL # (24 digits): �O-OMQOQCQ <br /> RECEIVED STAMP(BELOW): <br /> TAX ID#: �� I MUSE U1E <br /> ", " I'll <br /> BURNETT COUNTY <br /> ZONING STAFF ONLY ABOVE THIS LINE ZONING <br /> `Applicant Complete All Sections Below This Line <br /> Property Owner's Name: `T;jh(1 -r PJ('P.�SQ�.r <br /> Applicant's Name: `^n T <br /> Applicant's Mailing Address: <br /> City State Zip <br /> Applicant's Telephone Number: 1 I D�� <br /> Applicant's Email: n I )t I,P ZC� �_ LA n , cm m <br /> If staff has a question about this applicatio how do you prefer to be contacted? Check one below: <br /> Letter Xphone ❑ Email <br /> Legal Description: —R\ t4\.3 <br /> Lot#: CSM Vo1. u 47n g. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: >7 Town#:_N Range#: I(P W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br /> Parcel#04 digits): D ? `O 3 Z-Z - �I 'I —3S-3 Z"3 -D00-0/74700 <br /> Tax ID#(1-5 digits): <br /> Lot Area: ft-' and 5,) 5 0 acres <br /> Property Site Address#: Road Name: IF—T V ck -- <br /> Anticipated Start Date: C <br /> Section#of the Ordinance this CUP is referencing: -30'J �� <br /> Page 1 of 4 <br /> Burnett County,WI Conditional Use Permit(CUP)Application—Rev 3/2015 <br />