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CONDITIONAL USE PERMIT (CUP) APPLICATION — Burnett Cogi ,,WI <br /> $300.00 CONDITIONAL USE #: CUP-2 d <br /> FEE: J ZONING DISTRICT: A <br /> PARCEL# (24 digits): 01 01(0 <br /> a " 3 a a -,► - 0IIow <br /> oo RECEIVED STAMP (BELOW):[^� <br /> TAX ID #: �l'`l ✓ 3 2i5 Js 3cz`'T <br /> IECEIVE <br /> APR 0 4 2023 <br /> LAND SERVICES STAFF ONLY ABOVE THIS LINE Burnett County <br /> Land Sorrice3 Dcpar(rmni <br /> Applicant Complete All Sections Below t his Lime <br /> Property Owner's Name: 0,panA 1 t (Y x <br /> Applicant's Name: F wLt' A Ev ot-‘ ) <br /> Applicant's Mailing Address: C <br /> City State Zip <br /> Applicant's Telephone Number: Is_ to- do&L'Q <br /> ` <br /> Applicant's Email: Q,me4N(1v Si 1 u(of ') erw er . o <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: Q CnLG( c <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR q 1/4 1/4 <br /> Section#: �3 Town#: t 3 N Range#: r W Town of: 1;,y dill <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): b1 0117E 2 t ' 1 1 '33 r O 1 -co® -Ji I `-'JD <br /> Tax ID#(1-5 digits):_ _ 1011 U <br /> Lot Area: ft2 and o W acres <br /> ail I�� <br /> Property Site Aduress#: c(QL l( Cc I tyJ <br /> Anticipated Start Date:iaC (. 0 <br /> Section#of the Ordinance this CUP is referencing: 53 <br /> Page 1 of 4 <br /> Burnett County, WI Conditional Use Permit (CUP) Application —Rev 1/2021 <br />