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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line C. <br /> co <br /> Permit Types and Fees:(Please,check appropriate boxes) a.^ <br /> 0 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 I n' <br /> '''.6,..,.c, <br /> Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ' O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ��, <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ' ° <br /> Filling/Grading $150 Boathouse $500 r <br /> a '\ <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> CA <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. T , <br /> Property Owner's Name: V Li K RI,dy c ��cecnjo, /vc:j 9f-F;1 o •z <br /> Property Owner's MailingAddress: 7 'O t ` k rNt'�6�-/ rl�'l/r �� <br /> p J / �, , I/v C. o .! <br /> City State Zip t 11 <br /> Property Site Address: ✓l,"T 1 w n <br /> vp I <br /> Contact's Telephone Number: 7/ 5Pt <br /> — 9 l Q (' 90).-c-- Z+ . y t <br /> .� C <br /> Contact's Email: FJ 1-e),-ti L ' u I '_ G} n 1. i( •e r d <br /> / / <br /> Legal Description of Property: !� <br /> co <br /> Section#: Town#: / N Range#: / 1. W W Town of: 'f�lh �c.-4< <br /> 7 N ao <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p <br /> Tax ID#(1-5 digit number; found on tax statement): 3Z L/C <br /> Proposed Use of Structure/Addition: C me PCXj,'yt 'Fv (;ti-C 4/— <br /> ( /9��Y "' <br /> xAnticipated Start Date: �/3/Z(� (Home/Cabin;Commercial Business;Bedroom;Deck ere.) � <br /> C7 <br /> Building Contractor: Sewer Installer: <br /> -3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLYW <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: N <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 /> ...., -FN. <br /> i .1-kus D s P e4#'4 /' /5 -fir ,�� , ie how d 71Xe, <br /> Cam? 7rouPtd•0 <br /> IVs- 6e USt.1 -fir huwkaP 114��74,1 #1 . <br /> = Fee Rec: I �� <br /> '74/ ��in 7. <br /> Check#: 5 <br /> 4/ <br /> Date of staff site visit: S/ /,3 c�zi/ Initials of site visit staff: 3/' > <br /> APPROVED BY LAND SERVICES OFFICIAL: ATE: '- /ZO� < ^ —— <br /> GiC.� rn <br /> c" 1HTI <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF N)g T : <br /> �10 � <br /> ifiri <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT °`- 0 <br /> '.G:`�2 N Ct <br /> Transcendent: - Page 1 of 4 m °-< N <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 6/2020 m „ e <br /> � --- <br /> � <br /> H ► --- <br /> - , �, <br /> K <br />