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y <br /> CONDITIONAL USE PERMIT (CUP) APPLICATION— Burnett County, WI <br /> 20 <br /> FEE: $300.00 CONDITIONAL USE #: CUP4- 0 ZONING DISTRICT: <br /> PARCEL # (24 digits): 0 7-1901-Z <br /> RECEIVED STAMP(BELOW): <br /> TAX ID #: Iop ZE E fi <br /> D � � t! <br /> Nov 0 b 1� <br /> Burnett County <br /> Land Services Department <br /> LAND SERVICES STAFF ONLY ABOVE THIS LINE <br /> Applicant Complete All Sections Below This Line <br /> Property Owner's Name: ©P�K �.14 K� i L L C <br /> Applicant's Name: b t4V i Cd <br /> Applicant's Mailing Address: 3� ` �^+ 20 (,Je(3S4e•2 LAJ-r J, —q0 �•� <br /> City State Zip <br /> Applicant's Telephone Number: <br /> Applicant's Email: Cl R I Ke yy C rMA1 I • Ca M <br /> If staff has a question about this application,how do you prefer to be contacted? Check one below: <br /> ❑Letter ❑Phone %Email <br /> Legal Description: �-Ar4kctw-d- p r,-b Ea r',,s47^ <br /> Lot#:T CSM Vol. Pg. 3 3-5 OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: Town#: _qpN Range#: 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): <br /> Tax ID#(1-5 digits): ?' / <br /> Lot Area: ft2 and ! / t acres <br /> Property Site Address#: �/ (��'u / f/` S 74-Ir <br /> Anticipated Start Date: <br /> Section#of the Ordinance this CUP is referencing: 224� Q NQ 30'2 26610 <br /> Page 1 of 4 <br /> Burnett County,WI Conditional Use Permit(CUP)Application —Rev 1/2019 <br />