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• <br /> • LAND USE PERMIT APPLICATION — Burnett County, WI cr o r <br /> b <br /> cn N <br /> Applicant Complete All Sections Below This Line 5. <br /> CD I <br /> Permit Types and Fees:(Please,check appropriate boxes) ,- a' <br /> p <br /> �( Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ?; <br /> CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> v( Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 k <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250V <br /> n '� ' <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)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 p...., <br /> Ilk <br /> v) <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. z. <br /> • <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 /> • , l r g. <br /> Property Owner's Name: 13r /!n•� T7 Cd.i_4 s.,c°.-Th o z <br /> Property Owner's Mailing Address: J-/ "SU f L' St /?I 2/c ,d✓'^$1 C44 4 3 8 <br /> 7- <br /> City Sate Zip a <br /> Property Site Address: ) X (4 CT/ c sa.+,p1 d E, - Si,,1e0/ v <br /> Contact's Telephone umber: S0 7 - 2 PS- p 7 9( I►' <br /> Contact's Email: Ani cr c, A C45-e-4,1 ela 0 Oli7.4 tc1yj <br /> Nd0 <br /> Legal Description of ProertY2C J 4cfeS GN 5E40E- s C <br /> r <br /> N <br /> Section#: 2 W Town#: * N Range#: / 7 W Town of: a 0 so <br /> oo <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C7 <br /> Tax ID#(1-5 digit number; found on tax statement): 33 ill <br /> Proposed Use of Structure/Addi ion: Ce4 h r 4...1 i'',(7- • <br /> Anticipated Start Date: 5 C r b er i-/ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) x <br /> 6 L) AJ✓lG.� <br /> 'I'41 .- : ).) <br /> Building Contractor: Tu� Sewer Installer: �^ka►c ��. � � <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ( W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 0 -' <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellin s, dwelling additions,manufactured homes,manufactured z <br /> home additions, and bunkhouses.** xi <br /> 0 Ole e4 Cal 44D <br /> s <br /> e, 6c r4 e 11 d4 ,' Lm Lb, b'c o <br /> ) <br /> a O,NelI1 - j e'kceed 3 ,od perS4$)- 1-3 <br /> = Fee Rec: P <br /> Check#: 5 k-, <br /> a <br /> Date of staff site visit: 1 3 I' 4 Initials o .ite visit staff.:iii z <br /> APPROVED BY LAND SERVICES OFFICIAL: 11 � / DATE: o�08•2/0/, ''' .� <br /> w <br /> UPON APPROVAL: APPLIC • ►. MUST POST COPY OF a3> <br /> �c a) 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ' 5'co <br /> . 0 o <br /> Transcendent: - Page 1 of 4 •m z Q <br /> Burnett County, WI Land Use Application-Rev 12/2020 <br /> • <br /> Laserfische: - g WO <br /> a <br /> K <br />