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APPLICATION FEE: $250.00 CONDITIONAL PERMIT#-13Lq— ZONING—E 7— <br /> (For Office Use only) <br /> BURNETT COUNTY ZONING ADMINISTRATION <br /> BURNETT COUNTY GOVERNMENT CENTER <br /> 7410 COUNTY ROAD K,#102 JIM FLANIGAN <br /> SIREN,WISCONSIN 54872 (715)349-2138 <br /> ....................................................................................1 <br /> COUNTY OF BURNETT CO <br /> cN <br /> �DITIONAL USE APPLICATION ZONING COMMITTEE <br /> (I) (WE) �\�00 Q ln� ��c C w'D 1 wC <br /> i2-f 60 ssew�,� � F� v lc�. � �y S`f8 <br /> (MAILING ADDRESS) (TELEPHONE) <br /> HEREBY MAKE APPLICATION TO THE ZONING COMMITTEE FOR A CONDITIONAI, PERMIT FOR THE <br /> FOLLOVv■NG: <br /> eL'I'vkeOT CYIJhm4' (CA S4 oI Arrcy6-j1fo�l, wA 15o 'or1—AA f-Mayr <br /> r' <br /> LEGAL DESCRIPTION OF PROPERTY: PART 0f NE� Sec 4 737NRirw� <br /> FIRE#: 2 Z4G0 ROAD NAME: /aASSerhb/4 RoRO GA►1 of SY Skt Sec 33 7.?YA&/ily <br /> PRESENT IMPROVEMENTS UPON LAND: _W060 LII KE &C f CAMP <br /> PROPOSED USE: SA/11 C (CA Al ) <br /> LIST NAMES AND ADDRESS OF ADJOINING PROPERTY OWNERS: <br /> NOTE: A PLOT PLAN DRAWING SHOWING THE COMPLETE <br /> LOT LAYOUT WITH SETBACKS AND DIMENSIONS MUST <br /> ACCOMPANY THIS APPLICATION. <br /> APPLICANT SIGNATUREDATE 3 11 '2- <br />