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r <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line a I <br /> Permit Types and Fees:(Please,check appropriate boxes) °' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200kN <br /> Accessory Structure(Garage,Shed,etc.) L15 d Addition/Alteration to Accessory Structure $150 - O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ..4D <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 C) <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o <br /> Filling/Grading $150 Boathouse $500 1 <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> CP <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. 1. V <br /> Ft.*Communication Towers&Signs require a different application form;see corresponding application,and fees. r� <br /> *Items not listed above will be treated- H�as accessory structures,such as:pergolas,landscaping,etc. ib t-••t <br /> Property Owner's Name: �1 In ES L. 4- J A NDR Pt {E'/ES <br /> Property Owner's Mailing Address: (p$$2 J'3EWl tik.Y K,Jou , vJcoDattky r MA s5 f 25 0 1 <br /> City State Zip 1 <br /> Property Site Address: 284;9 (3ONNER LAKE Rd, LOAIJ13IA/ / w1 St{-830 . N I + <br /> < <br /> Contact's Telephone Number: (eoso 353 - 1 103(c, ° "' <br /> c <br /> CD <br /> al- <br /> Contact's Email: Jimke16% 48©3N^AIL, Corn o <br /> Legal Description of Property: rjo�Jbergs L r 2. CSI^ Ni i3 P 14s (pRT Lar 2.4,3) <br /> o m <br /> Section#: Town#:140 N Range#: IS W Town of: SACK sopj ° <br /> E' <br /> cm <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C7 <br /> 4 <br /> Tax ID#(1-5 digit number;found on tax statement): (pQ$ 61 2 �" <br /> Proposed Use of Structure/Addition: METAL CARPo1Cr -rote- OTDRIILYA SpA `4 <br /> Anticipated Start Date: AS SADA1 0,6 pomp.pomp. et,E (Home/Cabin;Commercial Business, H d-Bedroom;Deck;etc.) i <br /> ei <br /> Building Contractor: SELF Sewer Installer: hiJik <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY --O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r— <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z d <br /> home additions,and bunkhouses.** a <br /> c9IVo- &or h.mo ha b; ILII' <br /> Fee Rec: 150= <br /> IJ 6 Check#: '"74p! 3 <br /> Date of staff site visit: -3/1 /a�01?-1 Initials of site visit staff: 1_'I L rn <br /> APPROVED BY LAND SERVICES OFFICIAL: 441' DATE: 3//B/a J N <br /> < r <br /> sv <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF Efil <br /> g)•• <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT N• iliii'. <br /> 5'g N <br /> Transcendent: - Page 1 of 4 A, N. n� <br /> Laserfische: - <br /> Burnett County, WI Land Use Application-Rev 12/2020 m i a i I"'"! <br /> ' 3 <br /> 1 <br />