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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> Applicant Complete All Sections Below This Line ' <br /> Permit Types and Fees:(Please,check appropriate boxes) p- <br /> Dwelling/Principal Structure $300 X Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 c--- <br /> Accessory <br /> 'Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 i 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Cam 2 <br /> y pground Structures $125 WlState Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 C. 1 <br /> Six Month Camping Unit(One Per Year) $100 _ Permit Extension(1 Year Extension-Allowed Once) $100 ,"-- lo, <br /> cn <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. CO (1. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. F g <br /> *Items r..'t listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> {{� r r <br /> ro <br /> Property Owner's Name: y3 G i aS L, aii't.c' 6 /o r- \ Yt O (K ° z <br /> Property Owner's Mailing Address: 5O /(et' N 5 Atd ,fol 3 Jam: • . S <br /> � �^/ <br /> city State Zip b [. <br /> Property Site Address: a� 7 5/ )`(-o h el (� a ` e..b0 51 r" 1,0_,r 5 S E- �; <br /> / 76, r9j�Contact's Telephone Number: -r)50-5 5-54 4,1 "3(e 3 --a2,„? / o F, L• <br /> CD I• <br /> Contact's Email: '1 o`C-‘cC vl ✓ �Q o V►t t,1 1, 6.0 i jL e <br /> Legal Description of Property: 1 Of 3 (rS M V :3 P ..o r ( ,k%) iG)(r Ca 11.4 1) co , <br /> Section#: 5 33 Town#: %4 ONRange#: 6 W Town of: oe K ( l 7‘ e <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> 7 <br /> Tax ID#(1-5 digit number;found on tax statement): i -3 c <br /> Proposed Use of Structure/A dition: t3!y y o O yy\. /S4-v r 4-�1 e.„ /G2 X J�, o H <br /> Anticipated Start Date: S//( c at <br /> (Home/dabin;Commercial Business;Bedroom;Deck;etc.) x <br /> Building Contractor: Se I }— Sewer Installer: r-- <br /> s_. <br /> y IP <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY lb W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: --a <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to w <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** :n <br /> CD N ed Pe- crMt -1-- c," move- + p she by G/1/2-i s <br /> Fee Rec:t2-OO°" <br /> N Check#: .31 a 1 <br /> e <br /> rn <br /> Date of staff site visit: 311(„I°2-I Initials of site visit staff: 14 L. r <br /> APPROVED BY LAND SERVICES OFFICIAL: � 6e;fiLX,,____DATE:311 e/2- arm <br /> 3 li <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF Po 1" <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT N �' <br /> c rV c4. <br /> Transcendent: - Page 1 of 451 <br /> �' <br /> Laserfische: Burnett County, WI Land Use Application —Rev 12/2020 t <br /> K <br />