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- LAND USE PERMIT APPLICATION—Burnett County, WI -� <br /> r <br /> b <br /> 1 N <br /> __ Applicant Complete All Sections Below This Line <br /> c <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 -2-: <br /> /Commercial/Industrial 15— <br /> Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 vc 1' <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 .....\ <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ..( 5. <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n (1 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 c N <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 <br /> rn <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. 5. <br /> *Communication <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. , <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> y <br /> a P.. <br /> Property Owner's Name: '''''a te .' / _ . . b. ' ? ^� <br /> Property Owner's Mailing Address: <br /> a8W2B CCC Rcl boo bvn ! 3G . <br /> 5�rn City State ZipPi <br /> Property Site Address: = n <br /> Contact's Telephone Number: a to F [-7 15 '1 2 o <br /> c. <br /> Contact's Email: KQ'<t'� 1 1.0 / fjW ejj <br /> J <br /> Legal Description of Property: - 4/ it .. 3 . 5 L.©--is.D. � <br /> (pls..)(pls..)In �� N r <br /> Section#: I, I Town#: �1 N Range#: 1(0 W Town of: Oa K La V)4 <br /> , <br /> *Attach additional page if needed_for lengthy description OR attach a copy of the Gleed OR attach tax system property page.* p <br /> Tax ID#(1-5 digit number;found on tax statement): 13 ! U <br /> Proposed Use of Structure/Addition: Sh-cc/ .1.--, ,, `r' <br /> c 73 <br /> Anticipated Start Date: ;3i /,a (7 Z-l (Home/Cabin:Commercial Business:Bedroom;Deck:etc.) '.i.--) x <br /> Building Contractor: Sewer Installer: I <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: /` m <br /> 0 N oc\- &c r- h‘014,1 h4.10,•+fio" z <br /> ® Ot eek c,ll 5e-}~134c1t5 <br /> r. <br /> Fee Rec: 11*7d <br /> c7 <br /> 4 Check#: c2/3 <br /> // I� I c <br /> Date of staff site visit: 3/14 pr) .1 Initials of site visit staff: ) .lam• MU <br /> APPROVED BY LAND SERVICES OFFICIAL: '�.�/L�/ DATE: 31/&1;"1 ¢ M ilw' <br /> t. <br /> UPON APPROVAL: APPLICANT UST POST COPY OF l W Cffd <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT s o Q� <br /> j N <br /> c N , <br /> Transcendent: - Page 1 of 4 jt�l <br /> Laserfische: - Burnett County, WI•Land Use Application—Rev 12/2020 <br /> z <br />