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LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> b <br /> Applicant Complete All Sections Below This Line 6 c <br /> Permit Types and Fees:(Please,check appropriate boxes) ° , <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 •'. ••••3 <br /> Commercial/Industrial 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 V'\ 21 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 '� <br /> t Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 r'- <br /> CA 146. <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. c <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 /> o <br /> Property Owner's Name: 6,;11.‘q..--, fi L P ," 6✓ ,. <br /> „ '4 z <br /> p <br /> Property Owner's Mailing Address: 9 //2 5/ (74 yi, 4-4 e 41/e o + <br /> -- City ate Zip $ <br /> Property Site Address: y 4 G --7 <br /> L� ��a-cl jt/e�ST Lt/St <br /> CA <br /> Contact's Telephone Number: 6-5/ 79‘ 1 pa 3 o <br /> ° <br /> E <br /> Contact's Email: g//6\i-c-4/4.,s•, s2- 0 G e'-t`t•� . C'''`-t d <br /> r <br /> d I <br /> Legal Description of Property: .. <br /> N b <br /> Section#: 31,E Town#: 4D N Range#: f 1 W Town of: Uri t f y) o °G <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 /> d <br /> Tax ID#(1-5 digit number; found on tax statement): ) 4 39 <br /> x� <br /> Proposed Use of Structure/Addition: ,'1/v-,'v- L'&-)/ <br /> Anticipated Start Date: 2--/Z- Z I (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) fx <br /> BBuilding Contractor: '-' Sewer Installer: C.-- <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 /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** • eh•�.es <br /> FM <br /> i5 4 &tr'"7o/l( � /10 64402( Sfi <br /> 2 X11 e4 a.li )e,1-b4 <br /> Fee Rec: �00 - <br /> y Check#: i 8'7 <br /> v <br /> �J m <br /> Date of staff site visit: / /I'6/9- ( Initials o site visit staff: 4 z , <br /> rEl <br /> APPROVED BY LAND SERVICES OFFICIAL: �/ DATE: VW?' < I <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a I C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ? 0 ,� G <br /> a� c <br /> Transcendent: - Page 1 of 4 rg n r <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 < . <br /> m („„c—........O <br /> 3 <br />