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• LAND USE PERMIT APPLICATION — Burnett County, WIcr <br /> Applicant Complete All Sections Below This Line E." <br /> Permit Types and Fees:(Please,check appropriate boxes) ¢• c <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> _ . <br /> , <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> �A cessory Structure(Garage,Shed,etc.)( _ 0 Addition/Alteration to Accessory Structure $150 o <br /> I Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 Ci�.3 P <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> p. <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °< <br /> Filling/Grading $150 Boathouse $500 r- > <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> n I <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> \y <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. <br /> ��n P <br /> ))k/tD 4 M M-I MO af�S5bti1 <br /> PropertyOwner's Name: o <br /> g49.0 .130x. 16 10I13uiey vii 9.1-S3a 0 . <br /> Property Owner's Marlin Address: /� ('ity State Zip -c9- <br /> Property <br /> o <br /> Property Site Address: gm 4,69..... cm eoDt ( 1 <br /> Contact's Telephone Number: 11)1A • V05 • 1v4 3 o r, <br /> Contact's Email: rnQ,lf' YY1o1(i 0/YY�,i 1 • (Do v10+1� c <br /> y ) - , <br /> Legal Description of Property: Lo} LI- tsM 4' (pg Vol 48 p31 'Retorod as Doc L1.058b <br /> 0 <br /> Section#: 5b4, Town#: Ltom N Range#: rb W W Town of: da, Q4A4, <br /> cm <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C <br /> Tax ID#(1-5 digit number; found on tax statement): 35 Lyn <br /> Proposed Use of Structure/Ad itio1 d I[ 10 <br /> 1 <br /> (o 1 iht a 1 4 " <br /> H H <br /> '').-7) <br /> Anticipated Start Date: 30 ► (Home/Cabin;commercial Business;Bedroom;Deck;etc.) 9 �e <br /> H <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY V' <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ' <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.**** ` ���� L (_ '1 �w� v <br /> O �0 (tQ IU T�'� <br /> Doee+ otil seri-becks <br /> z Fee Rec: I`JC�` <br /> LEzrn <br /> rn <br /> Check#: R48_2 <br /> Date of staff site visit: 60' b ) Initials of -te visit staff: I r- <br /> z <br /> 0 <br /> APPROVED BY LAND SERVICES OFFICIAL: / / DATE: 6/25/61..„/ < ""' <br /> UPON APPROVAL: APPLICAN ��UST POST COPY OF 4'4 frE <br /> i 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Nil1x1 <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: Burnett County,WI Land Use Application — Rev 12/2020 � U' <br /> — <br /> c '—' <br />