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• <br /> ' LAND USE PERMIT APPLICATION — Burnett County, WI a g <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) °. <br /> X Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d d, <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ."D 9) <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> C7 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 °< o <br /> Filling/Grading $150 Boathouse $500 C-, . P <br /> o — n <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. & y <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. cD <br /> `C r • <br /> - <br /> Property Owner's Name: '�m <br /> k' o- � to <br /> y T. 0((AO o.. ° z <br /> P <br /> Property Owner's Mailing Address: lei E\MC%Cep r E6-)0 4 -,Ry M i4 5,S I ZS g 1 <br /> ` , City State Zip bn 5) <br /> Property Site Address: M c, \ if q L�ctiY�'S Lok = n e <br /> E <br /> Contact's Telephone Number: (as t- ;LV3 ` 0 IA (D Io • <br /> l _ a <br /> 0. <br /> Contact's Email: rY ia.0 'CO Corr-K.GST . h� CCD7 <br /> In <br /> Legal Description of Property: LOT 2. c.c.- CSM W6-1`1 VOL. 3?(s, 3r' k-' C-'.°4 1:6--'eV <br /> N e <br /> Section#: 35 Town#: 4-1-0 N Range#: 1 W Town of: Ta-(\5¢Y\ <br /> 5�_ 00 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* O <br /> Tax ID#(1-5 digit number;found on tax statement): Ce 2 4 ' <br /> O <br /> Proposed Use of Structure/Addition: --r'r :a.\ G c-Ct�c--c\N--)6-\ (Re5;d2.xnc„,'e_l C o- A\c-N <br /> Anticipated Start Date: t b f Zy/20 2,1 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) le, <br /> E x <br /> Building Contractor: A-'2- C oc k a'n Sewer Installer: lauccleAA c J S4<1 (LC R(' <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY P <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.** : <br /> y m eek a 0 5e-�-b 0 <br /> Lb ®tee ti kv e•>i,e� ? be '46 i)e( 561ki- fl1 • ).Ll o <br /> t ,„ ,�,,,+ 'C�p+ c, c ,gee - x Fee Rec:3DD ' <br /> 1----, Nee Atte 55 "t �1 y Check#: 37 <br /> / 71 Date of staff site visit: 16) Initials : J to visit sta • ..---�i� E <br /> APPROVED BY LAND SERVICES OFFICIAL: ��, ' � DATE: �Lg/O11 74 <br /> y <br /> UPON APPROVAL: APPLIC • MUST POST COPY OF <br /> CD I <br /> 5 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z <br /> Transcendent: - Page 1 of 4 EnLaserfische: - Burnett County,WI Land Use Application—Rev 12/2020 $1d <br /> b <br />