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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line = Fl <br /> Permit Types and Fees:(Please,check appropriate boxes) a ° <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 se <br /> a <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> a_ X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 © <br /> Accessory Structure(Commercial/Industrial) $200 ,ddition/Alteration to Bunkhouse $150 ci <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk )( Bunkhouse $250 <br /> ,N <br /> Driveways/&Campground Structures $125 WI State Statute 59.692)ly)Structures $350 CTI° 0 <br /> Filling/Grading $150 Boathouse $500 C- ) <br /> o e <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> ciD <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. c G <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 /> �. A. \W- IkV-V 0$$L C j cLU SC' CTat't RM1 vita- o{� <br /> Property Owner's Name: z <br /> 0 F. <br /> S�61 c►t� < uA���� �a r��w� n��,�s M� •�S�t3q a <br /> Property Owner's Mailing Address: o <br /> ��,G`� Co 1(n b C. n r City State Zip b <br /> Property Site Address: v) A <br /> c � <br /> Contact's Telephone Number: 6 11, `�'`f 3 61` • b p'� 2 o N '.\' <br /> ,rte /� Altit- <br /> /� n. <br /> Contact's Email: T r t �A I LL i I-h LLW A ` 1`- COW <br /> Legal Description of Property: LOT 3 C'S M V to P 336' (st GOVT t r ? ) <br /> Section#: 1 6 Town#: Lj 0 N Range#: I S W Town of: a TLSO"1 <br /> 5. <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): 0-1-Oh 2-2,- 4 0 -15-16-5" 05-00g <br /> P 02) SGMEW ED po lic 4 3) cn <br /> Proposed Use of Structure/Addition: �($ <br /> Anticipated Start Date: S• a-l l k (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) �5� o <br /> Building Contractor:GLC-. EA4G1t- Nil tL\ Sewer Installer: /--' C <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY CIS <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 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured Z <br /> home additions,and bunkhouses.** z <br /> MI (fr e&- au S S cH ,,,1 w S� <br /> a 114;5 er✓+t,4- i t ' WI— <br /> { 5c, ( P°� <br /> k� �a11 + Iry I ?1'''„ wive"... P oS� i NO So ros <br /> 0 �/ 5 � r re r►� tiu- <br /> .v be, letter! Del /G �Ntt il We tG = Fee .3045' <br /> ;c..' I(Are, <br /> Date of staff site visit: 7/27/?-( Initials •of to visit sta • �4 L.- <br /> APPROVED BY LAND SERVICES OFFICIAL: / /% DATE: 7/ /d'i < <br /> tri a) <br /> RI <br /> UPON APPROVAL: APPLICA ' UST POST COPY OF a03 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 2 z.a) N <br /> n SI m <br /> Transcendent: - Page 1 of 4 7. w C era <br /> Laserfische: Burnett County, WI Land Use Application—Rev 12/2020 ri '` ty <br /> o fl <br /> > LC--- ,) <br /> �`��,) <br />