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• <br /> Part C: Provide navies and addresses of all property owners within 300' of the parcel proposed to be rezoned. <br /> This must include all parcels(including vacant parcels) that are within 300'of the parcel proposed to be rezoned, <br /> including those across the road. Address for the owner would be their mailing address(where they get their mail) in <br /> many cases this may not be the site address. Attach additional sheets if necessary. <br /> Gt./ a 4% e4 /' 7' <br /> Part D: Signature and date <br /> (If applicant and owner are different then both need to sign the application.) <br /> THIS APPLICATION CONSTITUTES NOTICE THAT ALL IMPROVEMENTS ARE SUBJECT TO ACCESS AND/OR <br /> REVIEW BY THE LOCAL MUNICPALITY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT <br /> I hereby petition the Burnett County Land Use and Information Committee for an amendment to the Burnett County <br /> Ordinance and/or map to effect a change in the Zoning classification. I certify that the information I have provided in this <br /> application is true and accurate. I agree to permit County officials charged with administering county ordinances or other <br /> authorized persons to have access to the above-described premises at any reasonable time for the purpose of inspection. I <br /> understand that the petition application fee is non-refundable, regardless if the petition is approved or denied. I <br /> understand that the fee for this petition application is only for the petition request, and if permits are required for the <br /> project, those will require separate fees. I understand that partial or incomplete applications will be returned to the <br /> applicant resulting in the application being removed from the hearing agenda, and the submittal deadlines will restart. <br /> Signed <br /> (Applicant) (Date) <br /> Signed `-�'� r� � 64944)L____ <br /> (Owner) (Date) <br /> (If applicant and owner are different, then both need to sign the application.) <br /> Page 3 of 4 <br /> Burnett County, WI Application/Petition for Rezone—Rev 12/2020 <br />