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' LAND USE PERMIT APPLICATION - Burnett County, WI a r <br /> b <br /> Applicant Complete All Sections Below This Line 6' <br /> Permit Types and Fees:(Please,check appropriate boxes) ° Z <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 e <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> 4 Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 i...--.)....„ ,O <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 G <br /> y pg $125 WI State Statute 59.692(Sv)Structures $350 <br /> Filling/Grading $150 Boathouse $500 r P <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 ' <br /> c <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. w A <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. q <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. rD i <br /> Property Owner's Name: i''1 l 111 n R. o <br /> Property Owner's Mailing Address: 1cJ Mop 1 P. 3 t, L rde_}�n e 5 mit) SSO)), $ <br /> rJC)I'�©�cv'C'l l 1>1 �el. y�C LYl la Lit <br /> �State,S `'3Zip 5 n <br /> PropertySite Address: i c <br /> Contact's Telephone Number: LD SI O� o N <br /> • C <br /> CD <br /> c. <br /> Contact's Email: c14( I ) 0 6 (Yl 3[U, cC 1y-) b <br /> Legal Description of Property: t ,, (c,jt <br /> N or <br /> Section#: Town#: N Range#: W Town of: Oak In 0 cl c. <br /> *Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system propertyPaSe.* <br /> q <br /> Tax ID#(1-5 digit number;found on to tement): I` 515— <br /> ) k 14 <br /> Proposed Use of Structure/Addition: 0) C .,l lit 1�IQ115 <br /> Anticipated Start Date: (Home/CabiiCCo mercial Business;Bedroom;Deck;etc.) o x <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY F --r <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ^ C.0 <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to (vim <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured z V ` <br /> home additions,and bunkhouses.** PcJ <br /> 0 OttetA Ct Al 5 6k1D4 <br /> if> <br /> q A s t o�c.� 100 5e- r1eea�s A L uP <br /> eNal-l- ?U eKcees , beArcp pt 5 .4, „, ' , J 1 x Fee Recto��� <br /> c011o�,� 0. firl- o <br /> Check#: 3-u8? <br /> Date of staff site visit: 91?4 ' at Initials of •ite visit staff:_,� `' Z <br /> APPROVED BY LAND SERVICES OFFICIAL: fA / ///'/° DATE:1 01/41 x �r <br /> FD. <br /> .)" tJ, <br /> UPON APPROVAL: APPLIC •%Ay MUST POST COPY OF a Ii <br /> ff <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z o 0 0 <br /> -< m C r.3 <br /> Transcendent: - Page 1 of 4 m a� E--•YV <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 g <br /> a <br /> 3 <br /> b <br />