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CONDITIONAL USE PERMIT (CUP) APPLICATION—Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-15-.T ZONING DISTRICT:_ <br /> PARCEL # (24 digits):O7-Ca(}-2-q1)A L 5 I(7Q <br /> 2 RECEIVED STAMP(BELOW): <br /> TAX ID #: 3��53 � EC��1:1E <br /> AUG 24 2015 <br /> BURNETT COUNTY <br /> ZONING STAFF ONLY ABOVE THIS LINE ZONING <br /> Applicant Complete All Sections Below This Line /�/' 1 t- <br /> Property Owner's Name: Z c HA d 6. S44t44tl-tJj* -1 6f rAl 01 A�� A- S't 8C A <br /> Applicant's Name: :f>"E7 4-S -61) oc <br /> Applicant's Mailing Address: o, Jo 4 N q D A L.11 <br /> I, City State Zip/ <br /> Applicant's Telephone Number: 7 1�—p p(o[,> > 4 q 7 /� <br /> Applicant's Email: \_�C' 1 S f a C h T Q m OI MAIL •1,d0l <br /> -.7 ii; 34 <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: 6/ 15— <br /> Lot#: 1 CSM Vol. Z5 Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: ?j3 Town#:__!�O N Range#:_2y2 W Town of: Qg�t�dA <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): <br /> / � <br /> �O <br /> Lot Area: / ftZ and / acres <br /> Property Site Address#: -28 VS 7Road Name: 5o. 0 tl 1%35a r,) LK <br /> //(o <br /> _ <br /> Anticipated Start Date: I/ lI <br /> �f2 p <br /> Section#of the Ordinance this CUP is referencing: <br /> Page 1 of 4 <br /> Burnett County,WI Conditional Use Permit(CUP) Application -Rev 3/2015 <br />