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• LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5' <br /> CD I <br /> Permit Types and Fees:(Please,check appropriate boxes) o. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d 1 '):; <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 J <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 cl <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o 0 <br /> Filling/Grading $150 Boathouse $500 <br /> r <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 P <br /> C4 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. a <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. ro • <br /> 5 <br /> l I <br /> Property Owner's Name: 1:Cal `�.1 QC.,0 S©� o o IP <br /> Lys sL83U o <br /> Property Owner's Mailing Address: 7� fid' L t)a�bu►'t/�-f— I o <br /> �( o 111 \ -Rd LA iJct our y ` Stto ,Tp, �a <br /> Property Site Address: w 1 J� tf . <br /> Contact's Telephone Number: c j -938, 3o3 z/ \ o N <br /> Contact's Email: //'� -7 d <br /> Legal Description of Property: d f til VT� l/' <br /> Section#: ,•( Town#: N Range#: r W Town of: niekK, 'aA <br /> 0 0T <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* .q- <br /> Tax ID#(1-5 digit number;found on tax statement): /3118'6 (R' <br /> Proposed Use of Structure/Addition: "' <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Ex <br /> ] d <br /> Building Contractor: Sewer Installer: 1 <br /> y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY N .,... <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: W <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to 1 <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes, manufactured z ,Q 6\ <br /> home additions,and bunkhouses.** X) <br /> 6 744 pe wd- is fee a Za X 4(0 ucecssoryr s7Iiuc 4i <br /> 0 7,S Plruc4tre, 407474, d€ use.' N %a 1.4A47". <br /> z Fee Rec: <br /> En Check#:I561 <br /> o <br /> tr <br /> Date of staff site visit: 1///24074 Initials of 'te visit staff: t /• z <br /> APPROVED BY LAND SERVICES OFFICIAL: TE: 7/'74 Z/ / < y�'�' <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 4 . `— , <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 5 Es 4 ,1 <br /> Transcendent: - Page 1 of 4 n 0 - �' <br /> Laserfische: <br /> Burnett County, WI Land Use Application—Rev 12/2020 <br /> m <br /> v <br /> cna <br /> 3 <br />