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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 6" iNacn <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 >~ <br /> E <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> X' Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 O <br /> F <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 a <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 N <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 r <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. a <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. a <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: Er`k I,cJkk.4..., g z r <br /> ( k K A .tt44 /lqN rsll o <br /> 5r <br /> Property Owner's Mailing Address: �Icv a t �'' O o <br /> City State Zip a. <br /> Property Site Address: v. <br /> ‘, 5"./ - 020 <br /> Contact's Telephone Number: -. o g <br /> co <br /> Contact's Email: (i C o k t eh Kda vh-� <br /> , I e 4 a <br /> G CI <br /> w <br /> ro <br /> Legal Description of Property: .. <br /> oc <br /> Section#: 11 Town#: 3 9 N Range#: ) y W Town of: R v f K 7 <br /> *Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system property <br /> O <br /> Tax ID#(1-5 digit number;found on tax statement): 3 5 rq' 0 <br /> Proposed Use of Structure/Addition: (4✓'a q e.. c' <br /> Anticipated Start Date: )b_ I -. xo .% �/ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: .3oC j?vrs es" Sewer Installer: ! 7\): <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: —O. <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to O <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** ha.._,��7) %� <br /> _co( <br /> 0 e I 56+b' S <br /> ear °�`'� l ? <br /> �D 'u �� O� Jrt W�.k,,1 We�! '1 y Fee Rec:gs <br /> T�Uty Check#:1-4 <br /> glaiI; ► o <br /> Date of staff site visit: Q l n J Initials of%'e visit staff: ��� <br /> 010 <br /> APPROVED BY LAND SERVICES OFFICIAL: �� ` / �� DATE: '/ 7?/ a Cr <br /> UPON APPROVAL: APPLIC A'. MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT N <br /> • 3 <br /> Transcendent: Page 1 of 4in .— JI <br /> Laserfische: - Burnett County, WI Land Use Application–Rev 12/2020 < ��� <br /> m <br /> v <br /> -I <br /> a <br />