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CONDITIONAL USE PERMIT (CUP) APPLICATION— Burnett County, WI <br /> FEE: $300.00 CONDITIONAL USE #: CUP-19- l ZONING DISTRICT: <br /> PARCEL#(24 digits): 07-0 Z$- <br /> 1n 0-- <br /> TAX ID#: RECEIVED STAMP(BELOW): <br /> MAY 16 2019 <br /> Burnett County <br /> LAND SERVICES STAFF ONLY ABOVE THIS LINE Land Services Department <br /> Applicant Complete All Sections Below This Line <br /> Property Owner's Name: 0A ek,y y/ n <br /> Applicant's Name: 4 e l),e l f///1 !Z' /� U✓► z`°f�1 l�i�� <f^/LS f�$I��pI �7 KJ 11}�'10 d Jv <br /> Applicant's Mailing Address: <j t'O d 7�oj S/- L. -�/`�Z_`f�G It !7/� HAY Ssd 77 <br /> City State Zip <br /> Applicant's Telephone Number: - q-� 7 - _S-3 LlL/ <br /> Applicant's Email: -f1An16?1) 0 g Al Ct /,L . <br /> If staff has a question about this application,how do you prefer t e contacted? Check one below: <br /> .,�Letter Phone 2fmail <br /> Legal DescriptionZe0 S- To " () Ptv /'i Pe L C;f}V •C I O (LOT-)) -Td q � UAJ 1�� <br /> Lot#: CSM Vol. Pg. OR `ry S rn l --�ct 3/Zlc 44 <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> Section#: S Town#: r N Range#:�W Town of: SGe� <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: ff2 and �� - acres <br /> Property Site Address#: -l <b a c I�C►� <br /> Anticipated Start Date: QU'v ©� —6S5 _ cL� aricz <br /> Section#of the Ordinance this CUP is referencing: <br /> Page i of 4 <br /> Burnett County,WI Conditional Use Permit(CUP)Application—Rev 1/2019 <br />