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CONDITIONAL USE PERMIT (CUP) APPLICATION — Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-20-20 ZONING DISTRICT: — <br /> PARCEL # (24 digits): o7-0X--2-1H-16-3;5 03^coo-O/SDOO <br /> �QQr RECEIVED STAMP (BELOW): <br /> TAX ID #: ,�J pp((�� tr970 <br /> AY..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: r,( ) , L 1-1 r-.1, 7"t 'ie 9'`j'C'<1. <br /> Applicant's Name: 1:C L.i.,/4,Y; -S / i.'f A(( ./ <br /> Applicant's Mailing Address: 9 (/' S' To, en.e_.3. i' -YC ._j , <br /> City State Zip _ <br /> Applicant's Telephone Number: "/ <br /> - _ 329• , 3 " �t7 <br /> Applicant's Email: 6/ 2, L -- :pt '1 4) VA het), coe 6n <br /> If staff has a question about this application,how do you prefer to be contacted? Check one below: <br /> Letter 1 Phone 121 Email <br /> Legal Description: .SC.,c,. 5' i At 9/ ).,,j / b <br /> Lot#: Si CSM Vol. 41i 3 Pg. 12- </.i OR 467 0-5— `f <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR ) j/v' 1/4 ,-S 140/ 1/4 <br /> Section#: 3c- Town#: III N Range#: /( W Town of: -5 tii) i <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Parcel# its 24 digits):( g )� 0'J 0 3...:z. .7- Lir > 6 -3 3 -3 0 3 BGG °//CC)°' <br /> Tax ID#(1-5 digits): . J <br /> Lot Area: ft2 and ....C7 v acres <br /> Property Site Address#: &If (/Q ti 4p) V 4( L. R. it.1) 4 At ei/!'Id' l2✓-_ <br /> f 1 e/`67-.3(! <br /> Anticipated Start Date: $—,..2 S- - .2.C, <br /> Section#of the Ordinance this CUP is referencing: 30^O,(/7 30-5-94 9�'3 () <br /> Page 1 of 4 <br /> Burnett County, WI Conditional Use Permit (CUP) Application—Rev 11/2019 <br />