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LAND USE PERMIT APPLICATION —Burnett County, WI . <br /> Applicant Complete All Sections Below This Line 0 <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> sti Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 -^. <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 cp "h <br /> Accessory Structure(Garage,Shed,etc.) $150 _Addition/Alteration to Accessory Structure $150 O <br /> F <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0R <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk _Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °e �.l <br /> Filling/Grading $150 Boathouse $500 ro, <br /> o N <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. z <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. t[`\' <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. co <br /> CZ <br /> Property Owner's Name: p Cr^ �, \�,, p C o <br /> Property Owner's Mailing Address: \ \ ` p k)'�,,p��J\w .l-�y o� ,1„p, W-Sy��` o <br /> ��, (�,� City State Zip ,o ;4--s Property Site Address: ) � 06 -Vi4sS E.. <br /> �� U <br /> Contact's Telephone Number: � , 5 LA\AD o <br /> Contact's Email: C.O W LI T e t'lQ,,\\\(INA . \l.\Z. W U . (A,c. e <br /> F=,-' <br /> Legal Description of Property: <br /> `•� N -oSection#: 9Town#: ?j� N Range#: \y W Town of: 'QJI,.3QI� °Q <br /> Is. <br /> *Attach additional page i needed or lengthy description OR attach a copyofthe deed OR attach tax system property page.* <br /> * <br /> P g f f g Y P Y P P tJ P S P <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: H a PM <br /> .- <br /> Anticipated Start Date: It --1- Z o Z \ (Home/Cabin;;Commercial Business;Bedroom;Deck;etc.) o <br /> Building Contractor: Sewer Installer:S ept ivi�Z <br /> .� , W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY \ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **Tire 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,andburr� s.** x� �La�� �CA� S <br /> 1‘frte,U‘;) N91- 4rt7 <br /> cee( bed,Coo/ alioidiecS <br /> 0 sA - )-t- ilb r <br /> s Fee Rec: .3 <br /> K Check#: (4)4.p."-- <br /> o <br /> CC ^r L l rn <br /> Date of staff site visit:�J I d'� 2-I / I I Initials of ite visit staff- Y L rn <br /> 'a, o <br /> 5 i �, <br /> APPROVED BY LAND SERVICES OFFICIAL: fl // , ./�. / DATE: � • (1? < a ,m <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a CO CO CD C <br /> -pi cC i <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° o o ...0." <br /> -0p j f V <br /> Transcendent: Page 1 of 4tn r...‘'.1 i <br /> Laserfische: - Burnett County, WI Land Use Application -Rev 12/2020 < S <br /> rria <br /> Z <br />