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CONDITIONAL USE PERMIT (CUP) APPLICATION — Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-* 10 ZONING DISTRICT: - <br /> o7-0an- 2 - 40-/6 -3L-3 03-.000-0i/o00 <br /> PARCEL # (24 digits): 0 -o ZO - i ` YO -(6 -3 L•3 oy - OO-Of/pod <br /> 49? —07-1? -- 2- 1{D -/6-32-, O3- oov - o//ooco <br /> RECEIVFD STAMP(BELOW): <br /> TAX ID#:1�!3g1( 13go! IE © LE 0 V E <br /> D <br /> MAK 3 0 2021 J <br /> umett ounty <br /> Land Services Department <br /> 1 AND SI RV ILLS STAFF ONLY ABOVE THIS LINE ?L<It ' t 3bn <br /> ApplicantlComplete All Sections Below This Line <br /> Property Owner's Name: M 1 CY 1 n e. I W a H- 7 7 1 _-+- <br /> Applicant's Name: V ' I - -- '/� - "I J <br /> Applicant's Mailing Address:aria! ! 1L ;AI eK- LA)/ 5 Ct 3 <br /> City State Zip <br /> Applicant's Telephone Number: 7/5 - 8[a(o �" <br /> Applicant's Email: Li.)h "/CLI )(.tai/cj r)eSS @ hut ma; I .I()Vt. <br /> If staff has a question about this application,how do you prefer to be contacted? Check one below: <br /> 0 Letter 0 Phone Wmail <br /> Legal Description: S 1/a of Sw A. and ;(1 o-F44-1-i c S 15t <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: 3 c9,._ Town#: 40 N Range#: 1 (4) W Town of: FOLK--10.-sr '1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Parcel#(24 digits):(')r]- CGQ - 40 - 3 a - 3 O 3 -0o0 -0110c) <br /> O - 0 a o - a- LEO -I kp -3a - 3 04---000 -o tt o c, <br /> 09 -O d o - a - `I-o -1 t -3 a 3 -000 -o 0 Do ✓ <br /> Tax ID#(1-5 digits): l •• •,6C4.--11)" i 3 8 sS-,� t 3 cio / ✓ <br /> Lot Area: ft2 and 010 ro,/ U acres <br /> Property Site Address#: 5 i+e_, oc,I.rA 3 W 005-k r- <br /> Anticipated Start Date: 6X; t ShCa Yy$ RZ- 1 (.6 <br /> Section#of the Ordinance this CUP is referencing: _ a - t -38_• 1 3 <br /> Page 1 of 4 <br /> Burnett County, WI Conditional Use Permit(CUP)Application —Rev 11/2019 <br />