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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> e. <br /> Applicant Complete All Sections Below This Line <br /> CD I <br /> Permit Types and Fees:(Please,check appropriate boxes) .. e, U <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 `J <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 \0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 m <br /> -: <br /> ‘/ Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 � <br /> A Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 C- <br /> o , <br /> Six Month Camping Unit(One Per Year) $100_ Permit Extension(l Year Extension-Allowed Once) $100 <br /> AD <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. $ K--_ <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> r g <br /> Property Owner's Name: ( ar K v <br /> A- - 3'�.1�'1.1.- E bC-ol-'• 'f-eo , <br /> Y1 . <br /> Property Owner's Mailing Address: 2-1-3 2. 3 C Ave. Oreo l,L 0( 5 4 0 DD o , <br /> City State Zip <br /> Property Site Address: P 473 S (l rr.cA r 1 R. Lag 19s-ie-f W( 51151.3 FI n <br /> E <br /> Contact's Telephone Number: -7/5-- z//"7—.033O Z o 6 <br /> 1.- • a 9., <br /> Contact's Email: t (-3 e c?..5 ma's k, corr. d P <br /> CD ly <br /> Legal Description of Pro erty: L-o+ I C.5•014-�,S 3 V 3 X13 Lot' 2 C Owl -#�gL a VI. P 117 ll <br /> (i n G ov t, t ) T �11,or a L-K, a yhrt• '41 a /gbr i $9 aro <br /> Section#: Town#: 1�7 Range: W Town of: <br /> 5' <br /> ao <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C7 <br /> a <br /> Tax ID#(1-5 digit number; found on tax statement): 9't(1 <br /> Proposed Use of Structure/Addition: -Pi re Pit wrl'1. p*.Jcr,S / gide t eak .b.1 }vbu.S.e_ <br /> Anticipated Start Date: ?'k•+...-- 15- , 201k (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o <br /> Building Contractor: Ste_ 1-a4�rL Sewer Installer: kVA, <br /> y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY '� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r r <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 /> a), iV e Look -F c ain ae Sep1,'C bayt NI I .1' 4. <br /> x Fee Rec: c?S <br /> - Check l (A J) <br /> 6Ja5J i ..,, L ,.._________.0 <br /> Date of staff site visit: Initial of site sit staf '% �, <br /> Iiiiii <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:` Ia�/?-1 <br /> UPON APPROVAL: APPLICANT • UST POST COPY OF I ,...., <br /> 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ' <br /> Transcendent: - Page 1 of 4 g �. <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 (L____)) <br /> d <br /> a <br /> i <br /> b <br />