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LAND USE PERMIT APPLICATION— Burnett County, WI _ I (7 r" <br /> 7 <br /> Applicant Complete All Sections Below This Line 2 c <br /> Pt Types and t t r°i times) <br /> Dwelling/Principal Structure $300 Addition/AReration to Dwelling/Principal Structure $200 <br /> !' ,Col mernal;?t?diastriai Stru€t+ure33OC(X lAddition/Alteration.to CororrterciaiOndustnal Structure <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 I \+o <br /> Accessory Structure-(Cummer tJ^j str ai� :A€I:i'tscr:VA to rte*, zF to Bunktxot ,$-'_50 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> a Eat ri round Structures $ ? State S tate 4g_6! f,1v}Structures $1% f G <br /> Filling/Grading $150 Boathouse $500 c <br /> �Stx MonthCamping Unit l Per Year) $100 P it E zn t1 Year Extension-Allowed Once) � 1 <br /> U <br /> *NO1E:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> 'CommunicutianTowers&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. r, <br /> � <br /> & Lunkgn C • <br /> � 7 <br /> Property Owner's Name: S( ,.� -rs - r 1� o <br /> Property Owner's Mailing Address: 1 1 Zi-� ---0,00tin.Si IAridstm(1i Mi\igOIG y 4 <br /> g. <br /> ilrowy State Zi <br /> Property Site Address:m t_ A [b ........e. t.�i ' - 4 = s I) <br /> act � <br /> co0 CI <br /> Contact's Telephone Number. 0, ''...- Cc 4 � <br /> �- <br /> Contact's Email* a_o� � d k <br /> Legal Description of Property: j€ At-c iI ; <br /> Section It: Town II: N Range#_ W Town of: a r 1 ft <br /> *Attach additionalpage ifneeded or lengthy description OR attach a copyofthe deed OR attach tax. stern propertypage.* 03 <br /> f � P Pali ' <br /> Ore- 35 6( �; <br /> Tax ID#(1-5 digit number:found on tax statement): � `" '�-- ii' 1 '� <br /> Proposed Use of Stnrcture` dditio :OJWU x ire r� —See. of 4 ` ',. <br /> Anticipated Start Date: F� "-"F-W (HomelCsrhin:Commercial Business:1 - Bedroom:L%FA-in, <br /> kat:etc.) x <br /> Building Contractor: 7 �nstaller: V` Ad. hivs /zi , �.'AREA BELOW THIS LINE FOR LAND SERVICES STAFF COM MIENTSICNDI IONS ONL , Ul <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 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z aj <br /> home additions,and bunkhouses.** "� <br /> (, 6 5 r� ria I- �{ ��.t> . / 114..b;- .+ '61 <br /> O �� s sem- S pied ,c„r up,'r e i� SZ above, <br /> `;°Is <br /> w s . 15 <br /> Fee Rec: <br /> Check#: - <br /> r3/24 (� b 3 3C6 <br /> Date of staff site visit: +itials site vis staff z <br /> s 4 , /,/ <br /> APPROVED BY LAND SERVICES OFFICIAL: 4,.' ' Il DATE: /7'? < <br /> ZF, <br /> UPON APPROVAL: APPLICA UST POST COPY OF a a IN <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Transcendent: - Page 1 of 4 IV = <br /> r <br /> Laserfische: Burnett County,WI Land Use Application—Res 12/2020 < 14 << <br /> 5i <br />