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Part C: Provide names 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 /> 0 Wisconsin DNR 101 S Webster St, PO Box 7921, Madison WI 53707-tax id#13893 & 13902 <br /> 8 Susan Reynolds Etal 2305 Earl Ln, South St Paul MN 55075-tax id#13892;13899 93896 ''' <br /> Dorothy Wallace Rev Trust 27208 State Rd 35, Webster WI 54893-tax id#13954&11182'"--- <br /> u er r en <br /> Herzel Camp Assoc 4330 Cedar Lake Rd Minneapolis MN 55416-Tax id#13952 ' -- <br /> V. <br /> Self tax id's 35485, 35396, 11243, 11214, 112 5'4296, 11204, 1120 1200 36 Z 9 <br /> l q 7 <br /> l0 14,K. of 0alc-'0v.. atr.r P <br /> bli <br /> d GB DI51i4c - a Super r — C14t)4 ° . Soh <br /> 1111111111 <br /> 10 G6 014111c/ I SutPL'^Vi'Solam' OP'l&A 1 ►' <br /> Part D: Signature and date yaw1 it <br /> (If applicant and owner are different then both need to sign the application.) I 1 <br /> THIS APPLICATION CONSTITUTES NOTICE THAT ALL IMPROVEMENTS ARE SUBJECT TO CCESS AND/OR <br /> REVIEW BY THE LOCAL MUNICPALITY'S TAX ASSESSOR FOR THE PURPOSE OF TAX ASSES k IENT <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 'SL� Lif • 9-7?--Ana <br /> (Applicant)/ 11111 (Date) <br /> 01 -dr -A-- *-1 9-cZial <br /> (Owner) ' 0 (Date) <br /> (If applicant and owner are different, then both nee to sign the application.) <br /> Page 3 of 4 <br /> Burnett County, WI Application/Petition for Rezone-Rev 12/2021 <br />