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LAND USE PERMIT APPLICATION - Burnett County, WI ' <br /> . <br /> "til <br /> Applicant Complete All Sections Below This Line 3' . N., <br /> Permit Types and Fees:(Please,check appropriate boxes) a. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 e <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 '" t <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> 3 <br /> f <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 G� 0,6 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °e <br /> — S.) p <br /> Filling/Grading $150 Boathouse $500 0 <br /> Six Month Camping Unit(One Per Year) ° 0) <br /> p� g $100 Permit Extension(1Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aqui red 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. ro_ <br /> Property Owner's Name: ._ X .. S C�‘\,c ° <br /> CC..? <br /> i [� z <br /> Property Owner's Mailing Address: `� ? & 3 1-� ,,,, 't � 0 0 <br /> c city . State Zip -0 7' <br /> Property Site Address: -3 X 3 y�\'\ek^, Y.� j, Jebc �.1" 5I<rt13 r. n <br /> w � <br /> Contact's Telephone Number: C t S Tn -i 5/l 3 r <br /> i a <br /> Contact's Email: C,• \. —c - v I1 'W iI. - , v�,,�t �i d <br /> Legal Descripti n of Property: £ j04" ' 1k vj ,�q�j rid 311A );q <br /> c�JJ o ub <br /> Section#:a Town#: 4 0 N Range#: I W Town of: -..,,C.5344-- <br /> Crc <br /> *Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system propertyPa e.* <br /> P <br /> Tax ID#(1-5 digit number;found on tax statement): 5 5 / <br /> Proposed Use of Structure/Addition: S�Urc,. 7z) ") <br /> Anticipated Start Date: /1_,,c)(..%_../ Home/Cabin;Commercial Business;Bedroom;Deck;etc.) x <br /> Building Contractor: Sewer Installer: rd. <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY I <br /> VN <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Ui <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.** P:J <br /> FNlak all 5e-'- c . <br /> od- �r I • 1.0 Lt . v✓. <br /> x Fee Rec: /50Cla <br /> N Check#: <br /> `o <br /> m <br /> / IL-- <br /> Date of staff site visit: 2`1r �I Initials o site visit ff r <br /> nI , / o <br /> � <br /> APPROVED BY LAND SERVICES OFFICIAL: i - //QQ <br /> / // DATE: 7fO7p2/ li <br /> UPON APPROVAL: APPLIC A MUST POST COPY OF �5 z <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT " o <br /> N Na Q <br /> 0 <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: - <br /> n Burnett County, WI Land Use Application—Rev 12/2020 ..- IU <br /> L� .J <br /> n <br /> D <br /> 3 <br /> -o <br />