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CONDITIONAL USE PERMIT (CUP) APPLICATION —Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE#: CUP-16-J ZONING DISTRICT: <br /> PARCEL#(24 <br /> TAX ID#: <br /> RECEIVED STAMP(BELOW): <br /> J� <br /> D EC�L�N <br /> JUL 2 2 2016 <br /> BURNETT COUNTY <br /> ZONING STAFF ONLY ABOVE THIS LINE ZONINr <br /> Applicant Complete All Sections Below This Line <br /> Property Owner's Name: I 'l " - Gavaa <br /> Applicant's Name: �G <br /> Applicant's Mailing Address: VV C JI <br /> City State Zip <br /> Applicant's Telephone Number: 6o,-7 2-a2— 5( Z(., <br /> Applicant's Email: Y CO <br /> If staff has a question about this application,how do you prefer to be contacted? Checkje be w: <br /> • Q�,' _ I❑]Letter El Phone �Email I <br /> Legal Description: l Aaay_ ,\y Acre <br /> Lot#: CSM Vol. Pg. OR <br /> LA <br /> Lot Block#: Subdivision Name: <br /> Gov't Lot#: OR 1/4 1/4 T <br /> Section#:_S2% Town#:t PAN Range#: lZtEW Town of:�J <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): 0-7'-0 12— 2 —Tb —'S —Z7 —5 I r.✓- — 1©G —Q app 0 <br /> Tax ID#(1-5 digits): 1'2377 <br /> Lot Area: ft and 1 / acres <br /> Property Site Address#: 2 2 r; WArs-kk? <br /> I <br /> Anticipated Start Date: <br /> Section#of the Ordinance PiNUP is referencing: <br /> Page 1 of 4 <br /> l� nett County,WI Conditional Use Permit(CUP) Application—Rev 3/2016 <br />