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. LAND USE PERMIT APPLICATION — Burnett County, WICr <br /> w <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> Commercial/Industrial Structure $300 ition/Alte ration to Commercial/Industrial Structure `" <br /> Accessory Structure(Garage,Shed,etc.) $150 fi ddition/Alteration to Accessory Structure Z25 41561 '\ <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 CT1 -? <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 'az-, <br /> es,,, <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° lN? <br /> Filling/Grading $150 Boathouse $500 r- ��) <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 0 V1_ $ <br /> • <br /> * OTE:After-the-fact permits(permit a.uired after construction as•egun may cost up tot ree times the normal fee. = <br /> Communica ion owers&Signs require a different application form;see correspon•ing••• r • , .n• ees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: * "A-,c7 r t..)6, .2 <br /> -t 7 ( e A 6, o z r <br /> 1 .� <br /> 14, <br /> Property Owner's Mailing Address: /I D 5(. c.5 A n A,I h is/ 4,ik-z/A/ems 14/14 S,'1) <br /> City ate Zip <br /> Property Site Address: 49 C/ '5/ o c ,' JPJ 44)6 04ET <br /> Contact's Telephone Number: t /90" q/' L5-4-,& ? o <br /> CD <br /> C. <br /> Contact's Email: c.7 Po, u-e S 4. t a ct. C'o •..i' o <br /> CD <br /> Legal Description of Property: pc L. 5 c s ,..„-i & ao j,,;,,, RJ 32 'IS/C <br /> Section#: 3 Town#: 4/ N Range#: I,6, W Town of: ®i.+Ai 00 4 y . °C <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax/system property page.* p <br /> Tax ID#(1-5 digit number; found on tax statement): °'2"24/3[ <br /> Proposed Use of Structure/Addition: B®A T— -i-- CA 5--tc,le•q 9 h �' <br /> Anticipated Start Date: (Home/Cabin;Commercial'Business;Bedroom;Deck;etc.) , o- x <br /> Building Contractor: 6 <br /> (.....)A) <br /> Building Sewer Installer: <br /> -s <br /> AREA BELOW THIS LLNE FOR LAND SERVICES STAFF COMIMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: '' <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to VI <br /> • <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes, manufactured z <br /> home additions,and bunkhouses.** Pv <br /> OA- ;r J[N.rvlan 11 Ab h'0. n <br /> (p Nee t5 'eryi,'r1- ,v ( -J- 5heet 5e,& o& ex;54.Al e)hee4 <br /> — Fee Rec: Q.Z5 <br /> y Check#: A <br /> o 7> <br /> Date of staff site visit:3/11 /2.1 Initials of site visit staff: T/ N.L• 0> <br /> i T ' jc3J <br /> APPROVED BY LAND SERVICES OFFICIAL: ' : ,, A �,i,i/ DATE:3//'j/o2J -•'Pi ID <br /> Iiiiil <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF .W m <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ? co 0 w RI <br /> me1 5 ci <br /> Transcendent: Page 1 of 4 , =.< ,�; <br /> Laserfische: - <br /> Burnett County, WI Land Use Application—Rev 12/2020 < g <br /> l t� '/ <br /> 3 <br />