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Part C: Provide names and addresses_of all property owners within 300' of the parcel proposed to be rezoned. <br />This must include allparcels including vacantparcels) that are within 300' of the parcel proposed to be rezoned, <br />including those across the road. Address for the owner would be their mailing address (where they get their mail) in <br />many cases rnis may not be the site address. Attach additional sheets if necessary. <br />71379 :3 5'ul► �'L►---P�T►' l �' a DS <br />�I;LV`l r'ii.>' P","44---- - ✓lis atm <br />Part D: Sienature and dare <br />(If applicant and owner are different then both need to sign the application,l <br />1 hereby petition the Burnett County Land Use and Information Committee for an amendment to the Burnett County <br />Ordinance and/or map to effect a change in the Zoning classification. I certify that the information I have provided in this <br />application is true and accurate. I agree to permit County officials charged with administering county ordinances or other <br />authorized persons to have access to the above-described premises at any reasonable time for the purpose of inspection. I <br />understand that the petition application fee is non-refundable, regardless if the petition is approved or denied. I <br />understand that the fee for this petition application is only for the petition request, and if permits are required for the <br />project, those will require sep to fees. I understand that partial or incomplete applications will be returned to the <br />applicant resulting in the apation being removed from the hearing agenda, and the submittal deadlines will restart.. <br />Si ' /t �st-�` fGf ��✓s 1 s.�` l� - ! ,7- / 7 <br />(Applicant) (Date) <br />Signed <br />(Ow�etffie <br />er) ,( {Date) <br />(If applicant and owner aTrent, then both need t4ign the application.) <br />Page 3 of 4 <br />Burnett County, WI Application/Petition for Rezone — Rev 3/2017 <br />