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CONDITIONAL USE PERMIT (CUP) APPLICATION - Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-19 ZONING DISTRICT: <br /> PARCEL # (24 digits): o.Z'39 is'3Z -f� Ly%pp,�. pZS20o ��� <br /> TAX ID#: 0-0 RECEIION <br /> E <br /> 19_0tment <br /> LAND SERVICES STAFF ONLY ABOVE THIS LINE <br /> Applicant Complete All Sections Below This Line <br /> Property Owner's Name: J 84M jr J-- A .Q- ./Ld <br /> � f <br /> Applicant's Name: AY�� <br /> Applicant's Mailing Address: 5,-4A,0 <br /> City State Zip <br /> Applicant's Telephone Number: �71 6`3 <br /> Applicant's Email: d k4/yie ��?(J J111 fj(P&rJ1 G-6fi)7,? <br /> If staff has a question about this application,how do you prefer to be contacted? Check one below: <br /> ❑ Letter ❑Phone AEmail <br /> Legal Description: <br /> Lot#:R 2 CSM Vol. R-7 g. 3-1 OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: 33 Town#: 3 1�1 N Range#:__L5_W Town of: SLX,t'1d l_ 'Lloy . <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): 0-1 ' l-)aL(p-1z -3 Gi 5`39'S C)J cc),i o-,A 5 i tom; <br /> Tax ID#(1-5 digits): 5 C1 <br /> Lot Area: I V1,I q 4 ft2 and 4 �3 1 acres <br /> Property Site Address#: 5 �,Cl (' rj :r ( 5 Lt Zc? J <br /> Anticipated Start Date: ( <br /> Section#of the Ordinance this CUP is referencing: <br /> Page 1 of 4 <br /> Burnett County,WI Conditional Use Permit (CUP)Application—Rev 1/2019 <br />