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APPLICATION FEE: S150..00 CONDITIONAL PERMIT # ZONING__L 1__ <br /> (For Office Use only) <br /> xxxx***xxxx xx*xx***k*************sir**********************sir qtr*fir it********************** <br /> BURNETT COUNTY ZONING ADMINISTRATION <br /> BURNETT COUNTY GOVERNMENT CENTER <br /> 7410 COUNTY ROAD K,#102 JIM FLANIGAN <br /> SIREN,WISCONSIN 54872 (715)349-2138 <br /> . 1111 II 111111 I.II I 1 <br /> COUNTY OF BURNETT CONDITIONAL USE APPLICATION ZONING COMMITTEE <br /> (I) (WE) i9 s i/ d. .fl1/hi SoAl � _QLD -k11D1l,4-1s ---- <br /> 2 7 3D s" Clyy 121:A: rte_ �w� — � '7/S--6 3:c---g ------ <br /> (MAILING ADDRESS) (TELEPHONE) <br /> HEREBY MAKE APPLICATION TO THE ZONING COMMITTEE FOR A CONDITIONAL PERMIT FOR THE <br /> FOLLOWING: <br /> CeA/67-2u-c.1�0Aj ca '.' ,a.1.1/Jail/1/AL' t 110 v�L �'-GA-7 v. -- --- <br /> LEGAL DESCRIPTION OF PROPERTY:_rV E -Sid Ri`"t l,0 35 <br /> FIRE#: `L7 3v 5 _ROAD NAME:_&Cott ra,p £ty A------ --------- <br /> PRESENT IMPROVEMENTS UPON LAND: DEi uf�j., 36p na) Fleeiir4L <br /> It?e 1L efiAl S -S.kms 1 repti‹- u k 1�, Cd ------ <br /> _ <br /> PROPOSED USE: re Mf'm.r .(4;71//nee_ / ri <br /> LI T NAMES AND ADDRESS OF ADJOINING PROPERTY OWNERS: �-^ � <br /> .i `i 5p <br /> _t • :. Sc i 27 3.0 e7.-7( Q <br /> 2d. _Sad "ra,p <br /> ©wr e)ei-I< Lo re,ie; ldejlerage �'o - f� s ��It�al <br /> ra u r-6ma is a`74a(o Com, ted. N, Klebs ;v 548//'3 ------ <br /> NOTE: A PLOT PLAN DRAWING SHOWING THE COMPLETE <br /> LOT LAYOUT WITH SETBACKS ANI) DIMENSIONS MUST <br /> ACCOMPANY THIS APPLICATION. <br /> APPLICANT SIGNATURE _6-0--ac •"� — "(C. DATE ` 3_e). C/0 <br />