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CONDITIONAL USE PERMIT (CUP) APPLICATION —Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-17- IE ZONING DISTRICT:�R-3 <br /> PARCEL#(24 digits): 0 -7 -0, pC> <br /> RECEIVED STAMP(BELOW): <br /> TAX ID#: <br /> D EC"EOME <br /> JUN -7 2017 <br /> 0 <br /> BURNETT COUNTY <br /> ZONING STAFF ONLY ABOVE THIS LINE ZONING <br /> Applicant Complete All Sections Below This Line <br /> Property Owner's Name: <br /> Applicant's Name: <br /> Applicant's Mailing Address: qy &2 ic K 6 t I^ 77 'T 925A +g5 InI, <br /> / ` 2 City State Zip <br /> Applicant's Telephone Number: J ` )0$ - 7 <br /> Applicant's Email: /,S u 1 / IO�fj'+ct i Cork? <br /> If staff has a question about this application,how do you prefer to be contacted? Check one below: <br /> LL ❑Letter Phone Epfmail <br /> Legal Description: �Gt T J�t v�t2 S eG�t� H o rvi�s 467 1 <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 n1/4 <br /> Section#:��Town#:�D/✓N Range#: 9/6 W Town of: C)A K, La y��1 <br /> *Attach additional page if needed far lengthy description OR attach a copy of the deed OR attach tax system prupeny page. <br /> Parcel#(24 digits): 0 -7 - d a C> - • S l S -G� ^ U/ /cot, <br /> Tax ID#(1-5 digits): /4/ <br /> F f <br /> Lot Area: t 53o ft2 and `� b acres <br /> jr <br /> Property Site Address#: 2 ��o Pq{/ 1� Da V� U ✓/ <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 3/2017 <br />