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CONDITIONAL USE PERMIT (CUP) APPLICATION— Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-16- ZONING DISTRICT: / , <br /> PARCEL # (24 digits):0 7-01(OUD <br /> RECEIVED STAMP(BELOW): <br /> TAX ID#:1Q(40 <br /> Q EC"EVE <br /> APR 13 2016 <br /> ZONING STAFF ONLY ABOVE THIS LINE BURNETT COUNTY <br /> Applicant Complete All Sections Below This Line ZONING <br /> Property Owner's Name: /(%M f7A4- /7 �t'Lli ,O/L <br /> Applicant's Name: �PWC7�4 h� `/",L&591�( <br /> Applicant's Mailing Address:.X4� �')l(�3,_ 9/j <br /> City State Zip <br /> Applicant's Telephone Number: <br /> Applicant's Email: <br /> If staff has a question about this application,how do you prefer to be contacted? Check one below: <br /> ❑Letter N&Phone ❑Email <br /> Legal Description: ACZ S'W /1/E S/S 7"-3 yu R17V <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#:1,�Town#:,JQAL_N Range#:17W Town of: L io9jrd11 <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): d 7-01(d --2- 39--l? -SS / a-3- do - 004gy) <br /> Tax ID#(1-5 digits): l�( 7 <br /> Lot Area: ft' and acres ,,,,,/ <br /> Property Site Address#. O Road Name: 77 t�jT K.LGILA <br /> Anticipated Start Date: <br /> Section#of the Ordinance this CUP is referencing: /D S-13 <br /> /// Page 1 of 4 <br /> Burnett County,WI Conditional Use Permit (CUP) Application—Rev 1/2016 <br />