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LAND USE PERMIT APPLICATION— Burnett County, WI r <br /> a s [ <br /> b <br /> Applicant Complete All Sections Below This Line 0' a c <br /> Permit Types and Fees:(Please,check appropriate boxes) c. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> 6' <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ;6-- <br /> / Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 I � � <br /> AccessoryStructure Commercial IndustrialCA 2i <br /> (Commercial/Industrial)) $200 Addition/Alteration to Bunkhouse $150 2? <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ' <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 0 <br /> Filling/Grading $150 Boathouse $500 <. 1 A`1 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 ° ri <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. <br /> r <br /> Property Owner's Name: _Tref?e /`i, / //fl ° z ' <br /> c <br /> Property Owner's Mailing Address: 9.606 OO k Sf reef Dd/7hLrtl WI ,S 63e o <br /> City ! State Zip <br /> Property Site Address: 76.06 Oil/-- ,_5-i--reef �• <br /> c <br /> Contact's Telephone Number: 7/5-656 "3-zg o y <br /> Contact's Email: n. <br /> 0 <br /> w <br /> I FD <br /> Legal Description of Property: CTCV LC l L £X V ? 9 P 556 V 273 PJr,5 0 <br /> Section#: l l Town#: N Range#: `UO W Town of: `> <br /> c o0 <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> o <br /> Tax ID#(1-5 digit number; found on tax statement): w/g1Z- <br /> Proposed Use of Structure/Addition: shed /,5 crpye B!C/ 7 )0v, <br /> Anticipated Start Date: a- /- 2./ (Home/Cabin-,./Commercial Business;Bedroom;Deck;etc.) o x <br /> f _ <br /> Building Contractor:l4lllefl COM 5k.e/Cat pt i 4 Sewer Installer: /'4/`°fi' <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <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 /> V <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes, manufactured z <br /> home additions,and bunkhouses.** a.Ii tI,46 — 7J <br /> op <br /> No+ �� hi w h <br /> ? <br /> fileF CII( 5 <br /> Fee Rec: 115�� <br /> U Check#: �s'S�6 <br /> UDate of staff site visit: 60.-L1 1 Initials o, ite visit st. f: ` V > <br /> APPROVED BY LAND SERVICES OFFICIAL: jv/ ,1 �0 DATE:E " 5f? f r <br /> UPON APPROVAL: APPLIC • 'J UST POST COPY OF ' ("T2 <br /> SIGNED PERMIT APPLICATION '' .. • <br /> IN PLAIN SIGHT , al <br /> a r....1 t- <br /> Transcendent: Page 1 of 4 �- N <br /> Laserfische: Burnett County, WI Land Use Application—Rev 6/2020 ; o ,.. v, <br />