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LAND USE PERMIT APPLICATION - Burnett County, WI <br /> b <br /> cn 14 <br /> Applicant Complete All Sections Below This Line 0 <br /> Permit Types and Fees:(Please,check appropriate boxes) n W <br /> DwelIing/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 1..› <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 P <br /> - <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 N.,_ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 r- ' <br /> Six Month Camping Unit(One Per Year)) $100 Permit Extension(lYearExtenslon-Allowed Once) $100 <br /> v) <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. =F , <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 /> _ 2. - <br /> Property Owner's Name: (.iOz(.i,( {S(.3S A,...) C6 if t 0 J g/3 z c� <br /> Property Owner's Mailing Address:?D d�1�t�0�?� ptLlru1 i..)605t4 <br /> l -1-1 <br /> or <br /> City State Zip -0 <br /> Property Site Address: jhr^•e— 7 n <br /> Contact's Telephone Number. '`?t5) 'n 65 • S (4: o - <br /> Contact's Email:S i t s AA.Co L.117-f--42.2"a v 0 t t a ti. C.-e.,v•- 0 1 <br /> Legal Description of Pro e 7L /2_ 6 �t/e2c. Ark.—, <br /> v ��P rty <br /> Section#: ?� Town#: 3 7 N Range#: /CCS W Town of: . <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> p <br /> Tax ID#(1-5 digit number; found on tax statement): 1 a7/1 <br /> Proposed Use of Structure/Addition: 1De. K g v' <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) £ x <br /> 710 r; 5. <br /> Building Contractor: ps6.3 . %/0--''S Sewer Installer: t <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF CO`I1iENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 0 <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 <br /> home additions,and bunkhouses.** <br /> / �c- mkt Me- ;v <br /> , -7-14 ►'j e, 4.4/ <br /> 4th <br /> ,o ,,,o ,, Sid/e of - 1.71 <br /> , <br /> Fee Rec: 10,52) <br /> K.K. Check#:_9 L 9 <br /> Date of staff site visit: 'L $/WZI Initials of site visit staff: /Z , <br /> APPROVED BY LAND SERVICES OFFICIAL: �« — TATE: V / 04e / yR1' <br /> m 0 <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF . •§ 30 <br /> fil:m t <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTD c <br /> sv N <br /> Transcendent: - Page 1 of 4 ., -� <br /> Laserfische: triiii <br /> Burnett County, WI Land Use Application—Rev 12/2020 R. , <br /> Lc_____. � <br /> D <br /> 3 <br />