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Provide names and addresses of all adioinin2 property owners. <br /> *Adjoiners are all parcels(including vacant parcels) that touch the applicants parcel, including those across the road and <br /> those that only touch at a common property corner. Address for the owner would be their mailing address(where they get <br /> their mail) in many cases, this may not be the site address. Attach additional sheets if necessary. <br /> Dennis and Barbara BLODGETT - 7596 HAYDEN LAKE RD, Danbury, WI 54830 ax rd; 13v/41 <br /> Todd and Lynn SHELLENBARGER - 7683 GLENDENING RD, Danbury, WI 54830 TX +V, 13000 4130/Z. <br /> GREEN FAMILY TRUST - 227 1 STAVE NE, Winnebago, MN 56098 ��. l 300� g 13013 <br /> tSteve and Karen FERGUSON - 12796 OAKHILL RD N, Scandia, MN 55073 f id: Iy3Q0 <br /> Scott and Julie ERICKSON - 598 VALLEY VIEW TRL, Somerset, WI 54025 d7 td;Richard and Cindy STONER - 1496 95TH ST, New Richmond, WI 54017 1? ,*W 1�f30Z <br /> Ga and Tami DAVIDSON - 29174 FRENCH RD, Danbury, WI 54830 fax +d' 13065 i30 6 <br /> y T David and Jan MONTGOMERY - 29191 E YELLOW RIVER RD, Webster, WI 54893 <br /> Dennis and Darlene SEVERIN - 16213 HASTINGS ST NE, Ham Lake MN 55304 laird:jyZ9s 07 <br /> YBEHRENS REVOCABLE TRUST - 29492 130th Ave, Welch, MN 55089 («r /4' 13003 <br /> 1! 7lom 0 -16 Da/�la�Q/ C/e✓,� <br /> • Proposed building/structure locations must be staked prior to submitting this application to the <br /> Land Services Department. County staff will do an onsite visit to verify site conditions. If site is <br /> not staked upon County staff visit this application will be returned to the applicant. Returned <br /> application will result in the item being removed from the hearing agenda, and the submittal <br /> deadlines will restart. <br /> • If all existing structures are not shown and dimensioned on the plot plan drawing the application <br /> will be returned to the applicant. Returned application will result in the item being removed from <br /> the hearing agenda and the submittal deadlines will restart. <br /> • THIS APPLICATION CONSTITUTES NOTICE THAT ALL IMPROVEMENTS ARE SUBJECT <br /> TO ACCESS AND/OR REVIEW BY THE LOCAL MUNICPALITY'S TAX ASSESSOR FOR <br /> THE PURPOSE OF TAX ASSESSMENT <br /> I hereby make application to the Burnett County Land Use and Information Committee for a Conditional Use Permit <br /> (CUP). I certify that the information I have provided in this application (including any accompanying drawings and <br /> plans)is true and accurate. I agree to permit County officials charged with administering county ordinances or other <br /> authorized persons to have access to the above-described premises at any reasonable time for the purpose of inspection. <br /> I understand that the application fee is non-refundable regardless if the Conditional Use Permit(CUP) is approved or <br /> denied. I understand that the fee for this application is only for the Conditional Use Permit(CUP) application and if <br /> permits are required for the project that those will require separate fees. I understand that partial or incomplete <br /> applications will be returned to the applicant resulting in the application being removed from the hearing agenda, and <br /> the submittal deadlines will restart. <br /> Signed • r <br /> li 4- g1b IN <br /> (Applica t) 1 (Date) <br /> Signed . 0 <br /> (Owner) Date) <br /> (If applicant and owner are different, then both need to sign the application.) <br /> Page 3 of 4 <br /> Burnett County, WI Conditional Use Permit (CUP) Application —Rev 1/2019 <br />