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• <br /> LAND USE PERMIT APPLICATION— Burnett County, WI a <br /> Applicant Complete All Sections Below This Line a <br /> Permit Types and Fees:(Please,check appropriate boxes) o a. <br /> Dwelling/Principal Structure $300 }f Addition/Alteration to Dwelling/Principal Structure $200 <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 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 :; <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> C) <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °< <br /> Filling/Grading $150 Boathouse $500 o --- <br /> Six <br /> Six Month Camping Unit(One Per Year) $100 _ Permit Extension(l Year Extension-Allowed Once) $100 p <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. 6 <br /> 4 IL <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. , I► <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Ken h-�-+-ti H Fria k4 D Yt 5 z I <br /> Property Owner's Name: . <br /> IAr �.�I/ o <br /> Property Owner's Mailing Address: Zto I a 5 Old 35 Wt 251-e W I 54€ 3 g /.. <br /> City State Zip -a <br /> Property Site Address: 5 -e- <br /> 0 <br /> Contact's Telephone Number: 7I'5' 317 (, C <br /> ts�dabl�aufn 0...Vat LvYvt <br /> Contact's Email: o <br /> Legal Description of Property: <br /> Section#: Ie. Town#: 31 N Range#: `4O W Town of: Man oil g °O <br /> o' <br /> crp <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p <br /> Tax ID#(1-5 digit number; found on tax statement): I I 572- R. <br /> Proposed Use of Structure/Addition: garair, add i-h'oyi Cl.I aaith lino) <br /> Anticipated Start Date: (/ P (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> =><::}—.) <br /> �/1 T� <br /> Building Contractor: �J'��� Sewer Installer: <br /> 41 <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 /> ,1NI'construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z ? (. <br /> home additions,and nkh�atii8 -es." e ! Y <br /> 6Ie ell-- <br /> No4- ca- k n/tow f A-b, <br /> x Fee Rec: ../.Ot14) <br /> Check#: 4 <br /> Date of staff site visit: /�-7 i�-( Initials f site visit staff: o <br /> ltz <br /> rn <br /> 7`a87�� .� <br /> APPROVED BY LAND SERVICES OFFICIAL: t� �i `/ .DATE: < w - <br /> m m uu <br /> UPON APPROVAL: APPLICA,,''. MUST POST COPY OF w CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTZ oC7) fi <br /> Transcendent: Page 1 of 4 w c <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 12/2020 <br /> o ,* • <br /> - <br /> a <br />