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CONDITIONAL USE PERMIT (CUP) APPLICATION — Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE#: CUP-16-al ZONING DISTRICT: <br /> PARCEL# (24 digits): <br /> TAX ID#: 41_1q RECEIVED STAMP(BELOW): <br /> pfC�COlt <br /> SEP 28 2016 <br /> ZONING STAFF ONLY ABOVE THIS LINE EURNETT00UNTY <br /> Applicant Com Tete All Sections Below This Line <br /> Property Owner's Name: AP (1 6 CL+h C ko m Cl f <br /> Applicant's Name: u4rtaold <br /> (/ r <br /> Applicant's Mailing Address: D �a ) V 4 Vl 0 (1 ("— <br /> r� /�(� (i, 70 <br /> City State Zip s w,�i <br /> Applicant's Telephone Number:-115 - '(\J(0 q � (Q T �( <br /> Applicant's Email: �e��(-P_J`- co, <br /> cxj u h lJ � Q hQ o tC()m <br /> If staff has a question about this application,how do you prefer to be contacted? Check one below: <br /> ❑ Letter ❑ Phone id Email <br /> Legal Descri tion: <br /> Lot#: _CSM Vol. Pg. O(R� n <br /> Lot#: Block#: Subdivision Name: i-'a f U (1 S R l Ve r PORI <br /> Gov't Lot#: OR 1/4 1/4 /'� <br /> Section#: 77 Town# ON Range#:��W Town of-_0 <br /> *Attach additional page if needed for lengthy description OR <br /> R+attach a copy of the deed OR attach tax system property page. <br /> Parcel#(24 digits): <br /> D <br /> Tax ID#(1-5 digits): <br /> I q Z 7 <br /> Lot Area: ft2 and acres <br /> Property Site Address#: Sk �I "V CX '�v r6 <br /> Anticipated Start Date: <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 />