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CONDITIONAL USE PERMIT (CUP) APPLICATION — Burnett County, WI <br />FEE: $300.00 CONDITIONAL USE #: CUP-19- Z3 ZONING DISTRICT: 9 �-3 <br />PARCEL # (24 digits): 0 o�Z-2 - �f0 /f = 2/-1 DI- ODO -O/ ZOOO <br />CPS- $ tD <br />jY RECEIVED <br />TAX ID #: �7 / U FOWE ow C <br />SFPZ3219 <br />Land Services <br />LAND SERVICES STAFF ONLY ABOVE THIS LINE <br />Applicant Complete All Sections Below This Line <br />Property Owner's Name: 'r 8r I - <br />Applicant's Name: 'r1%a v+ts ,,J STOekl�;.y <br />Applicant's Mailing Address: 0,2603 S 3 oTit five tYl +�fc7 mo •� `�_. S�! i S1 <br />City State Zip <br />Applicant's Telephone Number: <br />Applicant's Email: -t%0 1A S. S'ico a k 1 .e.0 IQ, G t'1 -;. e® "i <br />If staff has a question about this application, how do you prefer to be contacted? Check one below: <br />❑ Letter ❑ Phone M Email <br />Legal Description: <br />Lot #: CSM Vol.ir2l qsr y/tPg. 2,03 <br />Lot #: Block #: Subdivision Name <br />OR <br />OR <br />Gov't Lot #: OR 1/4 1/4 <br />Section #: Town #: N Range #:W Town of: -: a GkSoyl <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): C 7 01 Z 2 1 C /S 2 i 1 0 1000 O 12,000 <br />Tax ID # (1-5 digits): <br />6r44 <br />Lot Area: ft2 and Ia . S/ acres <br />Property Site Address #: 2-F2 F/ C I gb C OE RS ! F IZ LO-L 7 4 913 <br />Anticipated Start Date: <br />Section # of the Ordinance this CUP is referencing: � Q — �-43 <br />Page 1 of 4 <br />Burnett County, WI Conditional Use Permit (CUP) Application — Rev 1/2019 <br />