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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> . b <br /> Applicant Complete All Sections Below This Line c 3,3 <br /> - <br /> CD I <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> n <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p� <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 �c F <br /> E <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(ly)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 <br /> I. <br /> o 6 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> cn <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. E. <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 /> iy WI L + e-II 0 -. ' <br /> Property Owner's Name: O�j z pa <br /> [! `,� r, woo a b�`y , 'pm) <br /> Property Owner's Mailing Address: 3(9 T /Y I 1 . VeVI'2 �s�Z 1 o <br /> �` /�� ,� tt City State Zip $ <br /> Property Site Address?-2-5 1)t 5 'lk° ft E U . 1 l� • bb Lk. / tor S g3O n <br /> rf E <br /> Contact's Telephone Number: 14-1 `TJ ` 30 .3"25 50 o <br /> Contact's Email: (/11ot�' V 1 62--&-m / L' 1 p <br /> w <br /> CD <br /> .. <br /> Legal Description of Property: <br /> WE BB L. ►� . b <br /> Section#: 24 Town#: i'r'i N Range#: W Town of: w <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 : 2-6,2-31 0 <br /> Proposed Use of Structure/Addition: Ira - <br /> Anticipated Start Date:Ct- ( 2.0 Z' (Home/Cabin;Commtnicfsa exit+Deck;etc.) o x <br /> ���-� ` e <br /> Building Contractor: )15..S Sewer Installer: <br /> -I / <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY r.......\ <br /> . <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: It**The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to r <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured z <br /> home additions, and bunkhouses.** <br /> DNom - or. Gti ��Q� h 44 b, -3, 4 <br /> ! _See a � <br /> x Fee Rec. <br /> 7Check#: / 71(i/ <br /> 9/17/? o ' __,tf,_3J <br /> Date of staff site visit: ./ oite vst. ' jIniti Issite �' - <br /> APPROVED BY LAND SERVICES OFFICIAL: , / %/ DATE: /5�/3 (?/ a <br /> r/ . v` ' c3 1 <br /> UPON APPROVAL: APPLICANT ' ' UST POST COPY OF � 'c' <br /> N <br /> SIGNED PERMIT APPLICATION IN PLAINct theCD C <br /> Q <br /> Transcendent: - Page 1 of 4 'j Ifthl <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 <br /> a <br /> 3 <br />