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LAND USE PERMIT APPLICATION-Burnett County, WI a <br /> y N <br /> Applicant Complete All Sections Below This Line ° r. - <br /> c. <br /> Permit Types and Fees:(Please,check appropriate boxes) e- <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> d <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 /> _,, Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 r <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 . o< <br /> Filling/Grading $150 Boathouse $500 t-, 1.1' <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 P <br /> a' - <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. $ r <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> ro <br /> Property Owner's Name: NiO tZ1 k NMP 1 C-e teS ti We, D gA -zy z <br /> P <br /> Property Owner's Mailing Address: P24 <br /> E• i <br /> 14, <br /> Property Site Address: b I 800 J1�I y /kD W2jj � State Zip 0 <br /> a ulill <br /> Contact's Telephone Number: 1 I • 1 J . a-ii <br /> So <br /> Contact's Email: f'i O �N& M?(2D I tib. e01A wow d <br /> MAIN► c <br /> Legal Description of Property: LO F I (13M V. 12 7g. An 3 t 1.,E 7 4* e Ng 44 Se tit <br /> EN <br /> o <br /> n <br /> Section#: eI Town#: 40 N Range#: 15 W Town of: i A i` 0. <br /> *Attach additional page ifneeded or lengthy description OR attach a copyofthe deed OR attach tax system roe page.** q' <br /> ./ b't P ��// Y property r't3'P S d (� <br /> Tax ID#(1-5 digit number;found on tax statement): J 14-4-2 5. <br /> 93 <br /> Proposed Use of Structure/Addition: bet-1C 10. r" <br /> H <br /> Anticipated Start Date: `'.k'/ 5t/`-i4 (Home/Cabin;Commercial Business;Bedroom;Deck; etc.) <br /> 1,, • , <br /> l!'r <br /> Building Contractor: Sewer Installer: ! <br /> H 0-1 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY S <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: —E. <br /> **The apj, i ,. .t,,:c;€- d,: ..,-); :i,,,'..1 ri-c;J l IA..212,Nicca_461 i0 lit,7e47Pille f ii ilk-Iliiii!.'Y 41Lc t e jw,i;1.:a 'm prior to <br /> .4NY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured 'z <br /> home additions,and bunkhouses.*" <br /> j2 i 4 I 4961— 491.11 56419 evtilL5 <br /> g Fee Rec: ba3 <br /> Check#: /S./2 <br /> to <br /> Date of start site visit: 6[/i7// te vit staff: <br /> Initials o .i ' Pi- <br /> i <br /> ,,,,,.... „, <br /> tri <br /> APPROVED BY LAND SERVICES OFFICIAL: •' / /"-- DATE: 6 0/02 I �---�J <br /> UPON APPROVAL: APPLICA MUST POST COPY OF y w co <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT . friiil <br /> ocox <br /> o <br /> Transcendent: - Page 1 of 4 g a r, <br /> Laserfische: - <br /> Burnett County,WI Land Use Application—Rev 12/2020 ` ' <br /> v. <br />