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LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> . <br /> Applicant Complete All Sections Below This Line 5" CID r <br /> Permit Types and Fees:(Please,check appropriate boxes) a' <br /> d 'Aj. <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 <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 .\ O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 G� '� '�— <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1y)Structures $350 5 <br /> Filling/Grading $150 Boathouse $500 r 93 <br /> 0 <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. o <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> ct <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> o 5• <br /> V <br /> Property Owner's Name: e_V tv\_- -e_(---sol‘ C,�h� C�, • -.Q 2h�' -e.lf\ z I <br /> o <br /> Property Owner's Mailing Address: Ida L r W �A5' <br /> G )-10,5+,,, s A,) 55633 g <br /> Li City State Zip $ '� "' <br /> Property Site Address: , 3 l V CO Y,-T • A i 1• ✓' I ' ,30 n <br /> Contact's Telephone Number: L I --,)-1 5 14\ 3 ! o N r <br /> CD fContact's Email: ik a& 42— . - +\T> d <br /> OD <br /> Legal Description of Property:3 P«5 ,,k VY SW AN ) H W V k)Q-S C- 3 g b f MOv Ai <br /> �u 1 ,/ N '-o <br /> . <br /> Section#: .5 , Town#:1-1-1i)V )N Range#:R 1)W W Town of: k) a'r °__. `� <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): 1 3 Ltc\ <br /> Proposed Use of Structure/Addition: Cckr o f----f- ' i\ <br /> Anticipated Start Date: G —2 -al u \ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) x <br /> Building Contractor: Self-- N <br /> Sewer Installer: A <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 <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured z <br /> home additions, and bunkhouses.** %n <br /> 0 eeA- al) S . <br /> 0 Nc+ ,r k�+✓ hab► .4,011 <br /> z Fee Rec:I5O' <br /> y <br /> Check#: WO <br /> Date of staff site visit: <br /> CI 1;'61 Ir ' Initia s of ite vis't staff: 7/ <br /> rriz <br /> APPROVED BY LAND SERVICES OFFICIAL: P4 �' DATE: 1I.�/�a I < <br /> UPON APPROVAL: APPLICANT'MUST POST COPY OF a G <br /> z3 -� CS <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z G <br /> gO G <br /> Transcendent: - Page 1 of 4 m g,4. o C <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 < - G <br /> ral a <br /> a <br /> E <br />