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LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> y N <br /> Applicant Complete All Sections Below This Line 8 a <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `t� <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> \ <br /> K Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 f <br /> Filling/Grading $150 Boathouse $500 S (l <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> cn <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. '. <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. r <br /> R,01\ Trope r-4)es LLC <br /> Property Owner's Name: , <br /> Property Owner's Mailing Address: t L& Cit-k- 0( j /`OA. S m I .5"" ta:7ii,„, <br /> ,�`�City State t .0 <br /> Property Site Address: 12(p) ej)Y-�V"1 S\ • r�JI1 x\{ WI _,Zip_ <br /> 'c0 Y. <br /> Contact's Telephone Number: �5J I ` t is�J'� + 11 ` .. F r <br /> �1 1 R <br /> Contact's Email: 3cmCVf S ��CQJ� .def\ i7 <br /> Legal Description of Property: �k- a C--S01 ". X14 \/ a 8 f lel <br /> A 0 .1 <br /> Section#: tot Town#: tO N Range#: ( L W Town of: CaK�C<.►`(` <br /> 5 <br /> 5. <br /> *Attach additional page i needed for lengthy description OR attach a copyofthe deed OR attach tax system properly page.** 04 <br /> P S .f S Y P Y P Pei'h'P S C7 <br /> Tax ID#(1-5 digit number;found on tax statement): 3 5501‘,0 a <br /> En <br /> Proposed Use of Structure/Addition: Ck <br /> Anticipated Start Date: AA e�i ) <br /> r� l7a 1 (Home/Cabin;Commercial Business;Bedroom;Deck;etc. <br /> Building Contractor: e.,-\-C Sewer Installer: _ _ 0 W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Vl <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: V� <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,manu actured Z <br /> home additions,and b`inkhouse x <br /> Neel 1bci + Ch**,ao n On a« 560-1 <br /> C. -ks Iff 0� �l��oZ <br /> 18 <br /> e✓I ce or S� la)e� ti✓le +lee d-v be- torhode) uP�.qC fir, ►�hee�- Se�� b �lll)1 _ <br /> 4-0 <br /> 75.v. kro, 0,�,na 0I �° y h <br /> Fee Rec: i d� <br /> 13) <br /> =''') Check#: 'Do/ <br /> m <br /> Date of staff site visit:3/3604 Initials o site vis'-staff: <br /> z <br /> APPROVED BY LAND SERVICES OFFICIAL: I )` DATE:✓/l�/)-1 < 0 <br /> Fi <br /> UPON APPROVAL: APPLICAN /- UST POST COPY OF y % <br /> `n �� 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT gill <br /> z Fig N <br /> Transcendent: - Page 1 of 4 , v n <br /> Laserfische: Burnett County,WI Land Use Application—Rev 12/2020 w g N Q <br /> a <br /> y Gild <br />