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CONDITIONAL USE PERMIT (CUP) APPLICATION - Burnett County WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-15-D ZONING DISTRICT: _ -d-- <br /> 07 Dao a t hail 3 <br /> PARCEL # (24 digits):p,7-pA-a—qCJ -1(o Z-1 —0I--p[L p I <br /> 137x3 07 0 i 33—� �f5 STAMP(BELOW): <br /> TAX ID #: <br /> )�1 <br /> ZONING STAFF ONLY ABOVE THIS LINE <br /> Apw <br /> P11'06nf Complete All Sections ]clow This Line <br /> Property Owner's Name: 13�q <br /> Applicant's Name: a A. Ac <br /> '' <br /> Applicant's Mailing Address: 1`t a v/0 � � VEL/ SA�I�D <br /> City State Zip <br /> Applicant's Telephone Number: <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: <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Town#: N Range#: W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed. <br /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): <br /> Lot Area: 8Z and acres <br /> Property Site Address#: Road Name: <br /> Anticipated Start Date: <br /> Page 1 of 4 <br /> Burnett County, WI Conditional Use Permit (CUP) Application-Rev 3/2015 <br />