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v, b <br /> LAND USE PERMIT APPLICATION — Burnett County, WI cr 2 <br /> Applicant Complete All Sections Below This Line 5' <br /> Permit Types and Fees:(Please,check appropriate boxes) a. <br /> Dwelling/Principal Structure $300 b./Addition/Alteration to Dwelling/Principal Structure $200 d . <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 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 \ \ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures 0 <br /> y pg $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 C• <br /> in Unit(One Per Year ° <br /> Six Month Camping g ) $100 Permit Extension(1 Year Extension-Allowed Once) $100 14 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. RAD <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 /> , o g, 1111 <br /> Property Owner's Name: S Com&� y,4 ;,, z <br /> Property Owner's Mailing Address: ..ZO �� St. /(,J L__-., t 't- ) /�,{:,_.,,,A- `�s �y( lb <br /> _ City State Zip a. <br /> Property Site Address: /0,91 (, flay .S t i .etf 14-.),G .� €' C)-1 cA <br /> Contact's Telephone Number: C ,,,i — 6 s ,( 7.2C. - ' 7 j- t 7 t,c`(f f o'le?7 o <br /> Contact's Email: /fit c '�"1 P�> k� c <br /> w <br /> co <br /> Legal Description of Property: <br /> Section#: 24 Town#: II( N Range#: i L( W Town of: 52,7-r- N ac <br /> " <br /> * Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> d Q� <br /> Ez <br /> Tax ID#(1-5 digit number; found on tax statement): (' .SSU j �J <br /> Proposed Use of Structure/Addition: deLt ( '�'+4s�kG� r)1.....- <br /> Anticipated Start Date: 0cx' 1 .202( (Home/Cabin;Commerc"ial Business;Bedroom;Deck;;etc.) o x <br /> Building Contractor: (''7'13 Li),,,e-11-C- 4,r-1 5 ttr•e/ wer Installer: L/&-c 13; t^ �,d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> .-3 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: n VI <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to 0 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z W <br /> home additions,and bunkhouse .** z <br /> (hQe-� at! 4kks <br /> OA/e1L0 vv4 (0 eXGeel 3 b iovpis per 5#1V-.2).)9 i <br /> Fee Rec: -26-Y.Y4P- <br /> r <br /> Check#:�j�C7 1 <br /> ni <br /> Date of staff site visit: 9 /2-1 2 I Initials ' site vi it s : �r z <br /> 0 /- // m <br /> APPROVED BY LAND SERVICES OFFICIAL: :t f/fr DATE: 10//3402i �o <br /> ff <br /> UPON APPROVAL: APPLIC A ei' MUST POST COPY OFa W m <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 o o <br /> Transcendent: Page 1 of 4 � ang` <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 3 <br /> d <br /> rna <br />