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CONDITIONAL USE PERMIT (CUP) APPLICATION — Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-23- t5 ZONING DISTRICT: / <br /> PARCEL#(24 digits): -008'�2"3 '-/V-0 6 pf•,ppl—pll/e2:9 <br /> RECEIVED. <br /> TAX ID #: l `�tN� D� D V E <br /> Re „iitilde3ct Ie- 'N - JUN 10 2023 <br /> 2 <br /> �lI <br /> p q I Burnett County Land Se <br /> rvices Department <br /> LAND SERVICES STAFF ONLY ABOVE THIS LINE <br /> Applicant Complete All Sections Below This Line <br /> Property Owner's Name: IVY Or r'g J- 0 Ls?' <br /> Applicant's Name: F(2-An) 4 1 Alior <br /> Applicant's Mailing Address: 640 Moon L.oi a Qc #4 "1 W S ,5Y868 •0 <br /> City State Zip <br /> Applicant's Telephone Number: 11 5. (p 4 S- 01.50 <br /> Applicant's Email:4\14Q0 12 1 gp\ e '* o 0. co M <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is legible and <br /> your email provider will accept emails from the following addresses: @BurnettCounty.org and @BurnettCountyWl.gov <br /> Legal Description: Q <br /> Lot#: CSM Vol. VI Pg. 11 1 OR <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: I OR 1/4 1/4 <br /> Section#: 6, Town#: 38 N Range#: 1 y W Town of: D E W EY <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): Q') - 0 O F! -a -3 8 - ly - O(o •5 0S - 00 I - 011000 <br /> Tax ID#(1-5 digits): _�� 1 Q C( <br /> Lot Area: S as , L io 0 ft2 and I P acres �J <br /> Property Site Address#: AV/ <br /> Anticipated Start Date: OS-- c 0 a3 <br /> 30 - I? <br /> Section#of the Ordinance this CUP is referencing: � <br /> Page 1 of 4 <br /> Burnett County, WI Conditional Use Permit (CUP) Application—Rev 12/2022 <br />