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LAND USE PERMIT APPLICATION—Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line 5� � - <br /> Permit Types and Fees:(Please,check appropriate boxes) k-k) <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 g. <br /> CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $1500 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ^� <br /> i <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> G1 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 r0 c/ <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. e <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 /> CD <br /> Property Owner's Name: Leg_ -.. .- J i%-�.a..“-- \\--&—ti." r o <br /> .- 1 p <br /> Property Owner's Mailing Address: 546 & C=..\w 11�C r'A,/��klAh l`4 5557 <br /> City State Zip 11 <br /> Property Site Address: _: nr <br /> „ <br /> ED �4 <br /> Contact's Telephone Number: 3' �Ci� , / 1 c, <br /> a. <br /> Contact's Email: keaNv\(.tJJoec c \ c c' ' V CCA#\ d <br /> °' <br /> Legal Description of Property: / o <br /> Section#: 47Z 2`j 7 Town#: ..7_l N Range#: 19 W Town of: (..;, .d�"Pi �A <br /> g• tio <br /> cm <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ty <br /> Tax ID#(1-5 digit number;found on tax statement): 35 eaq o 3. <br /> Proposed Use of Structure/Addition: "' , <br /> Anticipated Start Date: (Home/Cabin:Commercial Business:Bedroom:Deck;etc.) f 5 <br /> Building Contractor: Sewer Installer: <br /> y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> mom- a, 5e-+-b�,s z <br /> t <br /> , fxP;reS 1110 /2-i x, <br /> 49c,,,mpet 4 be. &L►0 Cp/1.;tc4 fir, B17414 f <br /> &VI woLgbe V14147 ( VseP1h <br /> Fee Rec: 57)'‘:51' <br /> Check#: (a `?J <br /> Date of staff site visit: 1 7' Initials of ite visit staff: r ' iP <br /> I; ef5 POP <br /> .6/B /�1 m Il1C lamed <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: < <br /> n ► rL--t I <br /> J I <br /> / T POST COPY OF v <br /> UPON APPROVAL: APPLICANT , r- <br /> -i <br /> co <br /> a c...._ NilSIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 c <br /> ca <br /> 5'41 o <br /> Transcendent: - Page 1 of 4 S �- ((( <br /> Laserfische: Burnett County,WI Land Use Application-Rev 12/2020 < 8 <br /> 3liiffl <br /> LTJ <br />