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LAND USE PERMIT APPLICATION — Burnett County, WI b <br /> N <br /> Applicant Complete All Sections Below This Line 0 <br /> CD I <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> A <br /> )( Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 P <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `, d <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 , <br /> Filling/Grading $150 Boathouse $500 0 r....D. <br /> 777 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. 0 <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 /> rR <br /> Property Owner's Name: C o 6%4 4• tie-IA e4-v42c/ } + BizcKe G-vldS .,.%or+1,4 o <br /> J <br /> Property Owner's Mailing Address: Liao( Doo 9c. LIN N E. Oue\es dr-) (YIN 5-5-106 o <br /> City State Zip w I r 'im <br /> Property Site Address: a5 g 3 b kW 13aS> Loke )2-à Webs4-et` WZ 54 8"13 5. n —° <br /> Contact's Telephone Number: 5'O 7— a-l D -- LI D...1) 3 0 <br /> c I <br /> Contact's Email: a Oj • h e + e e c;4- �p cJ p"..e e c c V1 o <br /> Legal Description of Property: T C. L G- O si L. o 'T S '3 & y & Ni./1 S E <br /> = <br /> Section#: 13 Town#: 31 N Range#: l b W Town of: r(1 e en o 01 0 °0 <br /> ua <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C7 to <br /> Tax ID#(1-5 digit number; found on tax statement): l l '7 4`i <br /> Proposed Use of Structure/Addition: C.0.A n VD <br /> Anticipated Start Date: 9 — 1 — )-o`er I (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o x <br /> Building Contractor: G r e j 1‘,311‘,31 e-‘\- -t «r.4- Sewer Installer: 1-1opk n s (?) - o-AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY J <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 dditions,and <br /> bunklous .** axis CNS ext�ot 104 i )Yek c`Is <br /> pvtelli4. do+ c exceed 2 beoWo/ peww-) -aq I <br /> P'' <br /> 1 <br /> x Fee Rec.3�— <br /> L <br /> 4 Check#: /cg. f <br /> q L o <br /> Date of staff site visit: l Ii3/ I Initial'of site visit s r <br /> / z <br /> . /-- /��/ q <br /> //22 ��! <br /> APPROVED BY LAND SERVICES OFFICIAL: _ // � DATE: `/ 'f.) [(1( <br /> UPON APPROVAL: APPLIC •MUST POST COPY OF W -0 CSS <br /> =7 ffilil <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Transcendent: - Page 1 of 4 ;0` r.:-/ <br /> Nil <br /> Laserfische: - <br /> Burnett County,WI Land Use Application —Rev 12/2020 ' 2 `.. <br /> . = <br /> b <br />