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FOR OFFICE USE ONLY <br /> Conditional Permit No. Date - ]-�' Fee <br /> Hearing Advertised Notice Posted Property Owners Notified <br /> COUNTY OF BURNETTT CONDITIONAL PERMIT AAPPLICATION ZONING COMMITTEE <br /> (I) (we) <br /> Mailing address Phone <br /> hereby make application to the Zoning Committee for a Conditional Permit for the <br /> following: <br /> Gas 2-5 Gr, S���T� / T2.o-y�� T��/��� ✓ o ✓����E <br /> LOT DcJ ✓,5P /i1/le7 <br /> �'�/T Of` TNS dC� Ttfv�aT yY a1�7? Due f✓E T f .SErvJ 33 <br /> on the following property: Ta w,�_So37 4✓0/7W_ /1,� ✓�E iBWESz �aw ✓o��29rE <br /> (Legal Description) C/ u ✓ 5 c�� gu2,✓�,= Sri, d,- <br /> Lot <br /> GLot Size J 9C-�E Zoning District <br /> Present Use 7z-'f4,0c4- <br /> Present Improvements Upon Land i��'T/G Ty ✓/! � '-7-K- <br /> Proposed Use <br /> E� <br /> List names and complete mailing addresses of adjoining property owners: <br /> G ; ED2 00 ,-7f-ti/ <br /> EOJJ,�/6% Df�J�On/ -17,/ <br /> /Applicant Signature -7 <br /> � /z C �_ / l Date � <br /> Action taken by Zoning Committee: <br /> Signed <br /> Secretary, Zoning Committee <br />