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A <br /> CONDITIONAL USE PERMIT (CUP) APPLICATION—Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE#: CUP-19- ZONING DISTRICT: R <br /> PARCEL#(24 digits): <br /> TAX ID#: 2 Y 7 ! MP <br /> p RECEIVED STA (BELOW): <br /> DL5 ly LS V <br /> MAY 2 4 2019 <br /> Burnett County <br /> LAND SERVICES STAFF ONLY ABOVE THIS LINE Land Services Department <br /> Applicant Complete All Sections Below This Line <br /> Property Owner's Name: ' R G ((' A) ►nn T �� <br /> 1a I <br /> Applicant's Name: �� o 4 NW1N <br /> Applicant's Mailing Address: MN 7 u <br /> �y City State Zip <br /> Applicant's Telephone Number. <br /> Applicant's Email: Q A q I I 'G L4 `R, U4-e✓1,(/0 1m <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: �"L �0 q L 0)T �" l(✓ <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: a I Town#: 3'6 N N Range#: N-1 W Town of: D c�kA] I <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): ©? ^ 006 — Z— 3 -o//000 <br /> Tax ID#(1-5 digits): Z I -7 7 <br /> Lot Area: I ft2 and Q acres <br /> Property Site Address#: l LAN H U VE 0 z <br /> Anticipated Start Date: 1 y 7 � <br /> Section#of the Ordinance this CUP is referencing: 3d --�'S 7 30--5-m 386 <br /> Page 1 of 4 <br /> Burnett County,WI Conditional Use Permit(CUP) Application—Rev 1/2019 <br />