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LAND USE PERMIT APPLICATION - Burnett County, WI c <br /> ►v <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure <br /> $300 Addition/Alteration to Dwelling/Principal Structure $200 d bk)--- <br /> m <br /> • Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ` y 1 <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 SI <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 c <br /> n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o 1 <br /> Filling/Grading $150 Boathouse $500 r- r <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 o r\ k�� <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. d <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. v <br /> Property Owner's Name: 44A9/7 lierwXS z <br /> o i <br /> Property Owner's Mailing Address: ,..fA 77 3 ___1 c - 4 IL,',liii /),044i ��ygv o a <br /> City State Zip -a <br /> Property Site Address: s.�(„p ra <br /> Contact's Telephone Number: Ijs`% 4/ 'c - 49 9 c 4c rA <br /> Contact's Email: t., A /*s A / e�7z 7. i o <br /> Legal Description of Property: o .tl Tet."-n'‘ )---g...- + \I V t t (' 0 ,. <br /> N '-o <br /> Section#:_ i 1 Town#: y o N Range#: IS"- W Town of: J-4-�,cy- . c. °C <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* q <br /> s <br /> Tax ID#(1-5 digit number; found on tax statement): e 5/' 7 <br /> F. <br /> Proposed Use of Structure/Addition: , ,i ,� �Ull�>v <br /> f I <br /> Anticipated Start Date: �' in v <br /> p Ce• L v A (Home/Cabin;Commercial Bus ss;Bedroom;Deck;etc.) <br /> Building Contractor: i2 ...4(4-2-tc,�i Grp Sewer Installer: //26,,t/..e-- <br /> -1 <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 tr..... <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes, manufactured z <br /> home additions,and e �n M 4 b, 4v d 1 z <br /> gi Nol.- <br /> M94-- J 5e-4--baciL3 <br /> - Fee Rec: <br /> 7 Check#: 3;10 <br /> Date of staff site visit: /t{11)""1 Initials - site vi/'t staff: Z ED ' <br /> //02/ 'APPROVED APPROVED BY LAND SERVICES OFFICIAL: '1 '' / DATE: I 32. <br /> t, <br /> UPON APPROVAL: APPLIC • NT 1. ST POST COPY OF . <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT - N <br /> Transcendent: - Page 1 of 4 -0 Wit <br /> Laserfische: - Burnett County, WI Land Use Application-Rev 12/2020 i <br /> r <br /> 3 <br />