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LAND USE PERMIT APPLICATION—Burnett County, WI <br /> Applicant Complete Al!Sections Below This Line °' <br /> CO I <br /> Permit Types and Fees:(Please,check appropriate boxes) " <br /> Q <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 U.1 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150i)' ' rb <br /> x Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 e <br /> Filling/Grading $150 Boathouse $500 r- D <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) _$100 . <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. k <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. i, <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. Q` <br /> l , r 1. <br /> Property Owner's Name: '.1 A 6 p P4 _( (A) 6oC" n-(c6/0( L r z .., <br /> Property Owner's Mailing Address: eJ-76) S i q 1, /-/, 7 ' $t A._,.4_, ('t+'�5► yp7 $ <br /> City State Zi w <br /> Property Site Address: WS-70 5 /a-� 1�L,./ 7 Si /2,2/7.--„ G1/4/)S 5 Zip <br /> 5' n 6 <br /> Contact's Telephone Number: 7/S - J V ? 0 •0 <br /> Contact's Email: .a ci /let) V /J Al Ci--rig-is bC.•4-() CjGC/' . (_o it -6 • <br /> a. <br /> Legal Description of Property: tL t iW v v NJ in./ N tb& 1-4L6,(i KJ*10 O -7 6 v ' <br /> N <br /> Section#: l 3 Town#: ,�V' N Range#: I-7 W Town of: Da;)%-Lx <br /> ' <br /> *Attach additional page if needed for lengthydescription OR attach a copyof the deed OR attach tax system property page.* <br /> C7 <br /> v <br /> Tax ID#(1-5 digit number;found on tax statement): DQ6'1 g' <br /> Proposed Use of Structure/Addition: < <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) y x <br /> O <br /> Building Contractor: Sewer Installer: <br /> y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY p <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: t.J' <br /> 01111-ee* A.11 5e-1--bc,c,k,, <br /> Aie h z <br /> bco,�aitt ;n aro�ni )-015 b SIII)-( <br /> i Fee Rec: <br /> in <br /> Check#: 5"?-01/4-1 <br /> Date of staff site visit: fE'ti. of a visits ; i: j <br /> y �� . �' <br /> APPROVED BY LAND SERVICES OFFICIAL:-7a��� I'� DATE: / <br /> • -, COPYOF i� <br /> UPON APPROVAL,. APPLIC T ST POST m C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o o <br /> Transcendent: - Page 1 of 4 `< < <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 12/2020 i _ rn <br /> Cd lE <br /> S <br /> ..v <br />