2022/12/07 - LAND USE - CUP - Conditional Use Permit - CUP-22-15

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• Provide names and addresses of all adjoining property owners. *Adjoiners are all parcels(including vacant parcels) that touch the applicants parcel, including those across the road and those that only touch at a common property corner. Address for the owner would be their mailing address (where they get la their mail) in many cases, this may not be the site address. Attach additional sheets if necessary. 1?M7 faxdra a DMMic' Ottplo 637o 444frd Si'vr.0 Lox 51/$7Z 19.5349 ? P HG ZatA /SO3 $' UPlaaty ft V ) 19'Nahnvev. MAI 53'3 d`tz 19Sy3 lecndal/ f, kAlk 8rac,-w1QH 2e'sv 0 Ii'stlt cr At_ lYcts 1r1 s MA/.530 3 3 19Sy7 To um Nywiwy 6,3/6 S rr °� IAsittr^ or SS/893 ►?.06 6s'alard 4.9iyqr, Z7o 5 -4 S74 E/144 hi40Sii. .- G 6/2� D 19SyO I /9s'�f� 1 ( 0.' 7i^aey (,JooIrtiN 6o 43S'‘ 51rio.. W 4s,44, JJZ 193Q 19576 2'e'4Qr 4'S4aNNo4 SAJos7 d/ GSZ/ 2.6 Z "d :7' GOy•'1 it, AM)sso5*2 . Q I ctc?5 g4 //y/Vdd I4,k 1038 7 A/o 's4 Az/ Si Inv, bar SS'87Z I LS/1{ 5avv,es /1'1dhe/% F�Gr G /AO /4'/ 4y // S/i�v, I 5Y87 Z g y 0 7;71/0P) of .S / c/ 1,_____ 01 J Ale 1 € M4l'k- 1a 0 ZozZ /" • Proposed building/structure locations must be staked prior to submitting this application to the Land Services Department. County staff will do an onsite visit to verify site conditions. If site is not staked upon County staff visit this application will be returned to the applicant. Returned application will result in the item being removed from the hearing agenda,and the submittal deadlines will restart. • If all existing structures are not shown and dimensioned on the plot plan drawing the application will be returned to the applicant. Returned application will result in the item being removed from the hearing agenda and the submittal deadlines will restart. • THIS APPLICATION CONSTITUTES NOTICE THAT ALL IMPROVEMENTS ARE SUBJECT TO ACCESS AND/OR REVIEW BY THE LOCAL MUNICPALITY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSESSMENT I hereby make application to the Burnett County Land Use and Information Committee for a Conditional Use Permit (CUP). I certify that the information I have provided in this application (including any accompanying drawings and plans)is true and accurate. I agree to permit County officials charged with administering county ordinances or other authorized persons to have access to the above-described premises at any reasonable time for the purpose of inspection. I understand that the application fee is non-refundable regardless if the Conditional Use Permit(CUP)is approved or denied. I understand that the fee for this application is only for the Conditional Use Permit (CUP) application and if permits are required for the project that those will require separate fees. I understand that partial or incomplete applications will be returned to the applicant resulting in the application being removed from the hearing agenda,and the submittal deadlines will restart. Signed `' M ta I33joii:g., (Applicant) (Date) Signed iai/LU-[.-2—. ' • ` / (Owner) (Da e) (If applicant and owner are different, then both need to sign the application.) Page 3 of 4 Burnett County, WI Conditional Use Permit (CUP) Application—Rev 12/2021