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CONDITIONAL USE PERMIT (CUP) APPLICATION — Burnett Countv. WI <br />FEE: $300.00 CONDITIONAL USE #: CUP -19 I' Q I ZONING DISTRICT: <br />PARCEL # (24 digits): <br />TAX ID #:I q6 8> fi 13 g�-C <br />LAND SERVICES STAFF ONLY ABOVE THIS LINE <br />RECEIVED STAMP (BELOW): <br />DCEOV <br />NO 77 2018 <br />Applicant Co,M(S-eq <br />All Sections Below This NF1, <br />Property Owner's Name: CL i•' L- <br />Applicant's Name: 6L ' (L- l� <br />Applicant's Mailing Address: g6 <br />` / City State Zip <br />Applicant's Telephone Number: &4S / �'] �t6 <br />Applicant's Email: M P-1.r'u� cn rl • t ��.., <br />If staff has a question about this application, how do you refer to be contacted? Check one below: <br />[:1Letter Phon� r Email <br />Legal Description: W 16 - r <br />Lot #: CSM Vol. Pg. OR <br />Lot #: -3 `"r Block #: 11�9 Subdivision Name: 5 S Q O <br />Gov't Lot #: OR 1/4 1/4 <br />Section #: Town #: N Range #:—&--W Town of: e� �1 <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />07 - aLo -Z x-000 <br />Parcel # (24 digits): 6? 2 - y 2-G �, Y d C CD. <br />Tax ID # (1-5 digits): I L16 81� -3 -f <br />Lot Area: ft'- and / acres <br />Property Site Address #: U /§ I 1 `t'y A- 5� ✓J . t't J t.4 ✓' <br />Anticipated Start Date:/19 <br />Section # of the Ordinance this CUP is referencing: 3L -OJ �� �S7 �✓ �v �� <br />Page 1 of 4 <br />Burnett County, WI Conditional Use Permit (CUP) Application — Rev 3/2018 <br />