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CONDITIONAL USE PERMIT (CUP) APPLICATION— Burnett County, WI <br /> 17- 19 <br /> FEE: $300.00 CONDITIONAL USE #: CUP-M ZONING DISTRICT: <br /> 0?--0zF-Z--iz0 zel- -S OS��oo3�o/7ooO <br /> PARCEL#(24 digits): <br /> RE <br /> TAX ID#: C a D <br /> Z6 <br /> IUL 1 2019 <br /> Burnett County <br /> Land Services Department <br /> LAND SERVICES STAFF ONLY ABOVE THIS LINE <br /> Applicant Complete All Sections Below This Line <br /> taw nn <br /> Property Owner's Name: �/J �Sc�' �l l"i <br /> Applicant's Name: G/ DD <br /> Applicant's Mailing Address: T/!�i¢si�'d�✓ �i4��G �/`� �Ji��f /IlN ���5 <br /> City State Zip <br /> Applicant's Telephone Number: ✓��' � r - �� <br /> Applicant's Email: <br /> If staff has a question about this application,how do you prefer to be contacted? Check one below: <br /> ❑Letter Xphone ❑Email <br /> Legal Description: -LC �S/7n ��'/.�'/���-� 3 S7 AF <br /> Lot#: CSM Vol. Pg. OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section Town#: C N Range#:1;�—W Town of: <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): 0 �;L - ®v?T — ,? " �U " <br /> Tax ID#(1-5 digits): <br /> Lot Area: /�'� X X t hd` i acres <br /> Property Site Address#: / <br /> Anticipated Start Date: <br /> Section#of the Ordinance this CUP is referencing: G <br /> Page 1 of 4 <br /> Burnett County,WI Conditional Use Permit(CUP)Application—Rev 3/2018 <br />