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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line • c <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ` Z� <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 l.h\ <br /> v` f <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 r\ 4 <br /> o <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 I. <br /> CID ip, <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. <br /> Property Owner's Name: IVI` ,()h ias z t <br /> lb <br /> Property Owner's Mailing Address: C� S �- `(� 5 c <br /> City State Zip <br /> Property Site Address: Iedr `) <br /> Contact's Telephone Number: (Q5I 776 `4433o <br /> Contact's Email: flUhoas@_)coyvist-, �� ,3 d <br /> CD <br /> Legal Description of Property: It h, 1,,, add ID W �– <br /> .._, <br /> N roSection#: Town#: RangeF3 W Town of: J Q °` <br /> o [ Xn .. <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): B4 g 0' <br /> Proposed Use of Struc /Addition: Shed cA <br /> Anticipated Start Date�el,(\► j'( /�(Home/Cabin;Commercial Business;Bedroom;Deck;etc.) E '-3 <br /> Building Contractor: pia T(.f-IJ Sewer Installer: 7 <br /> y k <br /> 0 St <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 G <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** z <br /> IMS 4 tI Sc <br /> NtA itteetcon 1140 'vA <br /> z Fee Rec:__ <br /> 4 Check NI:klr <br /> b <br /> Z ' rn <br /> o <br /> Date of staff site visit:V f�/3/ -/ Initials o :ite visit staff: 041`—/ z <br /> /��/ C <br /> (� m <br /> APPROVED BY LAND SERVICES OFFICIAL:CA /, � DATE:8I 7 49 7, <br /> UPON APPROVAL: APPLIC A 'MUST POST COPY OF 4 <br /> t..._ <br /> G <br /> a P <br /> G <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z g N <br /> Transcendent: - Page 1 of 4 n 4 ( <br /> Laserfische: Burnett County, WI Land Use Application—Rev 12/2020 <br /> m a. <br /> a <br /> b <br />