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CONDITIONAL USE PERMIT (CUP) APPLICATION - Burnett County, WI <br />FEE: 5300.00 CONDITIONAL USE #: CUP -19 a 'ZONING DISTRICT: <br />PARCEL # (24 digits): d%-Od �' ' 3 $ - `� ' aZ-" a O J —0 o0 — Q J a(Doa <br />TAX ID #:2- S O S <br />11 <br />JAN 2 1 2019 <br />Land Services Department <br />LAND SERVICES S'T'AFFONLY ABOVE] I 11S LINE <br />Applicant Complete All Sections Below This Line I /� <br />Property Owner's Name: <br />Applicant's Name: ,�4Ttc.� KAV&'rcNq-,cQ-G <br />Applicant's Mailing Address: <br />City State Zip <br />Applicant's Telephone Number: �ta' i,LJS- iOt� 3 <br />Applicant's Email: J 1C quF Et E e�o15 (3)GMAT L. COCA <br />If siaffhas a question about this application, how do you prefer to be contacted? Check one below: <br />❑ Letter ❑ Phone (Email <br />Legal Description: Sec- %a T"\ 3$ 9!5k-1 SHAT QKi NE ►3V3 �- � ov <br />Lot #: CSM Vol. Pg. OR StA"c� (LD• ^7t7 <br />Lot #: Block #: Subdivision Name: OR <br />Gov't Lot #: OR I/4 1/4 <br />t <br />Section #: 2Z- Town #: 2n N Range P. _W Town of: n)" - <br />•Attach additional page rf needed for lengthy description OR attach a cony of the deed OR attach tar system property page: <br />Parcel # (24 digits): o-7 - c(o - oZ - 3's - 11- X " A 01- V00 1000 <br />Tax ID # (1-5 digits): a 5 o 5 <br />Lot Area: 112 and <br />b .(+SO acres <br />Property Site Address #:- CA3O, KD <br />Anticipated Start Date: (' 1 I' °-'O,c\ <br />Section # ofthe Ordinance this CUP is referencing: <br />Page 1 of 4 <br />Burnett County, WI Conditional Use Permit (CUP) Application — Rev 1/2019 <br />