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LAND USE PERMIT APPLICATION-Burnett County, WI b <br /> • <br /> r N <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) c <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 ,Addition/Alteration to Accessory Structure $150 � O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 • <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 '' <br /> 4 <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. S' , <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 /> 6 <br /> Property Owner's Name: i /. AI r„ 0. ' lmttnf 1116 <br /> Property Owner's Mailing Address: <br /> (o`tOI4 ..4 klala LP Dail/Neil RTC 541g 36 X <br /> / ,, City State Zip <br /> Property Site Address: Apf�i)ed6-r A r _()t m ber _ k, <br /> Contact's Telephone Number: -71 '- % . G/ c _ <br /> Contact's Email: odRI man nt31 (6 Epinal I, ( v C <br /> Legal Description of Property: L-Otj-rxvld 6r rniTH- T L <br /> Section#: Town#: _N Range#:� W Town of: E. <br /> t14eat 5 oc <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p <br /> Seen 1/Y1Pnt <br /> Tax ID#(1-5 digit number;found on tax statement): 3 <br /> Proposed Use of Structure/Addition: ( -1 "J <br /> Anticipated Start Date: 7[, ,ie , /5(Hoene/Cabin:Commercial Business:Bedroom:Deck;etc.) <br /> rj <br /> x Kau i 11 /1 A) - �. <br /> BuildingContractor: � Sewer Installer: .—... <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/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 (5Th <br /> ANY <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** z <br /> 01\10A- cor �wr'lan h�bt`-I�,�'d <br /> f <br /> Fee Rec: 1.5 <br /> UP- <br /> 6 Check#: 1 557 <br /> /30 ia" A L m <br /> Date of staff site visit: Initials f site visit staff: z <br /> o <br /> / /2 J < <br /> APPROVED BY LAND SERVICES OFFICIAL: Ai!..- �Y�/ DATE: �l J �! �' n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 3I In <br /> ffi <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° m <br /> Transcendent:_ Page 1 of 4 v, n rn Elul <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 12/2020 g 8 <br /> • <br /> 1 <br />