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CONDITIONAL USE PERMIT (CUP) APPLICATION —Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-22- 1 2.- ZONING DISTRICT: / - / <br /> PARCEL#(24 digits): 0?"0/$• Z-3 9-/6-3(/•5 05•00/-0//000 <br /> TAX ID #: 12 7 3 q RECEIVED ST?_DaEOVED <br /> / <br /> 37 ig� <br /> JUL 5 2022 <br /> Burnett County <br /> LAND SERVICES STAFF ONLY ABOVE THIS LINE Land Services Department <br /> Applicant Complete All Sections Below This Line <br /> Property Owner's Name: Michael Henricksen <br /> Applicant's Name: Michael Henricksen <br /> Applicant's Mailing Address: 6659 State Road 70 Siren WI 54872 <br /> City State Zip <br /> Applicant's Telephone Number: 715-349-2400 <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 Phone ❑ Email <br /> Legal Description: Gov. Lot 1 , Section 34, T39N-R16W <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: 31(Town#: / r N Range#: W Town of: Meenon <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): 074-018-2-39-16-34-5 05-001-011000 <br /> Tax ID#(1-5 digits): 12434 <br /> Lot Area: 310,300 ft- and 4.83 acres <br /> Property Site Address#: 6659 State Road 70 <br /> Anticipated Start Date: ASAP <br /> Section#of the Ordinance this CUP is referencing: Section 30-85(3) <br /> Page 1 of 4 <br /> Burnett County,WI Conditional Use Permit (CUP) Application —Rev 12/2021 <br />