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Date, of /Application UUNUI I lUIVHL FE-RI'Il I INUMDr- R <br /> s <br /> Date of Hearing APPLICATION FEE sc�u <br /> Burnett County Zoning Administration ZONING <br /> BURNETT COUNTY GOVERNMENT CENTER <br /> 7410 County Road K, #102 Phone(715)349-2138 <br /> Siren,Wisconsin 54872 <br /> -x--��--���--��-x--x--x--x-�-�-�-x-�-�-��-�-x-�-x--x--��c-�--�-x-*-x--x-�c-�-�-�-�-x--*-x-�-�--x--x-�-�--*�-�c--x-�-�-x-�t-x--x-�--*�--x--�-x--�-x-�-x-�c--x--x--x--x--�-��--�-x--�-x--��--x--�--x--x-�c--�-�-�-x- <br /> COUNTY OF BURNETT CONDITIONAL PERMITT APPLICATIO/N� :."' ZO/NING COMMITTEE <br /> (I) (WE) ,hC.tY� _ S ! L13 �rG�firca ' <br /> elb d-er (,4)L . 5 y8 9 3 &r)3 c9- <br /> Mailing Address Phone <br /> hereby make application to the Zoning Committee for a Conditional Permit for the following: <br /> � 64 fog c�,00ra� � � rra �3a <br /> Legal Description of Property f� �,� /(14/ as a�-- e 35 A,4 <br /> Fire # Road Name r <br /> Present Use W I �(� (1•�0� ram{ 1- 7'� .� <br /> Present Improvements Upon Land {'jf o'---e- <br /> Proposed Use <br /> List <br /> yNames and <br /> �/Addresses of adjoining property owners: <br /> V/X <br /> D*buN , WIZ <br /> 1 ►U <br /> ,4kro�4 <br /> S -�u <br /> **NOTE: A PLOT PLAN DRAWING SHOWING THE COMPLETE LOT LAYOUT WITH SETBACKS AND DIMENSIONS <br /> MUST ACCOMPANY THIS APPLICATI N** <br /> Applicant Signature Date -' ---Action taken by Zoning Committee: <br /> 01 �y > J <br /> Signed: <br /> cretar , Zon' g Commi tee <br />