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CONDITIONAL USE PERMIT (CUP) APPLICATION — Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-17-QL_ ZONING DISTRICT: <br /> PARCEL # (24 digits):6_1-02A4-k271-03U-7)12M <br /> RECEIVED STAMP(BELOW): <br /> TAX ID#:�ao <br /> E E'IgE <br /> DEC - 5 2016 <br /> BURNETT COUNTY <br /> ZONING STAFF ONLY ABOVE THIS LINE ZONING <br /> ((E�pplicant Complete.All Sections Below This Line <br /> Property Owner's Name: 1� o n= l 1 0 <br /> Applicant's Name: 1(_n Q $QAl( p <br /> Applicant's Mailing Address:PO D 3 1A)� I f!'n i L /nly SSH P <br /> pCity State Zip <br /> Applicant's Telephone Number: �p l a09 ' 1a 7 I/d_ <br /> Applicant's Email: d(f(tie bg4 M <br /> If staff has a question about this application,how do you prefer to be contacted? Check one below: <br /> // <br /> El Letter [g Phone Fl Email <br /> Legal Description: 40fl 1_5/77f#17M 0 f,263 M SWA16' <br /> Lot#: I CSM Vol. Pg. 20.3 OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Aq Town#: N I N Range#:_j jj�_W Town of: S W j f <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Parcel#(24 digits): d7-- D3a -a- V/ /lo - A T-/ - 0.3 -000- 012 Ooo <br /> Tax ID#(1-5 digits): 0 17 <br /> Lot Area: 35,332.�� ft2 and . 970 acres <br /> � <br /> Property Site Address#: /7 s <br /> 11& &Ll Q/" A P1 bur'V 621 <br /> Anticipated Start Date: N/A p y I <br /> Section#of the Ordinance this CUP is referencing: <br /> Page 1 of 4 <br /> Burnett County,WI Conditional Use Permit (CUP) Application-Rev 3/2016 <br />