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CONDITIONAL USE PERMIT (CUP) APPLICATION - Burnett County, WI <br />FEE: $300.00 CONDITIONAL USE #. CUP -17-,22, ZONING DISTRICT: <br />PARCEL # (24 digits): -I- �I-— �3 <br />TAX ID #:� <br />ZONING STAFF ONLY ABOVE THIS LINE <br />RECEIVED STAMP (BELOW): <br />ECIIERSE <br />OCT 32017 0 D, <br />BURNETT COUNTY <br />ZONING <br />Applicant Complete All Sections Below This Line <br />Property Owner's Name: l tI Il/�t1�,G" 1w J /W� ^ D <br />Applicant's Name: jl %% & �v )J _ / �/y�► ,[� 12 i7 u <br />Applicant's Mailing Address: q ¢3/ <br />City State Zip <br />Applicant's Telephone Number: '?S 2 ff �-- "S—/ <br />Applicant's Email: P) T-4114 /L% S 1— 6 y AHO -o - CO /%7 <br />If staff has a question about this application, how do you prefer to be contacted? Check one below: <br />%Letter Phone Eff-Email <br />Legal Description: C ©/ / % lis m V 2 2 <br />Lot #:19 CSM Vol. V Z7— Pg. 15 -1 -OR <br />Lot #: Block #: Subdivision Name: OR <br />Gov't Lot #: OR 1/4 1/4 <br />Section #: 61,100 Town # N Range #: W Town of: V(_ %)i ►y wIi(� <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 />Lot Area: <br />- 0 y`o -- /� - 39 lit - z9- / 02 -coo- 0/lsoo <br />3�- Z115�p <br />ft and I0 acres <br />Property Site Address #: y R C1 Z of r <br />Anticipated Start Date: Q o� l <br />Section # of the Ordinance this CUP is referencing: a 85(�i 4— 3DQLq / <br />Page 1 of 4 <br />Burnett County, WI Conditional Use Permit (CUP) Application — Rev 3/2017 <br />