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• LAND USE PERMIT APPLICATION — Burnett County, WI a 9 <br /> b <br /> cn IN) <br /> Applicant Complete All Sections Below This Line 0' <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> CD li\ <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 i <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 gO <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> (riveways Campground Structures $125 WI State Statute 59.692(1v)Structures $350 e' Si <br /> 0 <br /> Filling/ ding $150 Boathouse $500 C" S <br /> IP <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 0 -, • <br /> V) Ilk <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. w <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. a. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r <br /> o . <br /> Property Owner's Name: Q�MQl1 k• -}-�ZG o - <br /> Property Owner's Mailing Address: X1-\7 U card S} S . C,0-\-(4042..(--vreiri ,,A6...) SS(.3kG ;0,- <br /> City <br /> City State Zip $ <br /> Property Site Address: y_V.st. 3 04 1o.lr(1ekk w.N \-\e%Y ac. *tx vcs- n <br /> L;n c o\A . <br /> Contact's Telephone Number: \2 - '2.,..r.)2- � , \ o 70- <br /> i <br /> Contact's Email: 'R cm.A.c,,,nrxv p IAC vvv2. cow-, p <br /> w <br /> CD <br /> Legal Description of Property:L pk 3 O c b..J c(\Qr C,„,rhor y Gera-;Cf,4 S.1 r J e %MciP ., <br /> sk5c6‘2 N <br /> Section#: \ Town#: - C,‘ N Range#: 1 '=} W Town of: L ;gc_U,.A . 0 °G <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> d <br /> Tax ID#(1-5 digit number; found on tax statement): 5�� <br /> 3.D 'FT <br /> Proposed Use of Structure/AdditionT Z1\Ift....JCa "' <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) rl k <br /> Building Contractor: Sewer Installer: �,,/ o v <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY y I <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: p <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.** ;o <br /> n O1 e e+ 411 s4b‘k. s <br /> ,, (Ij t5- i 14c- 9O w.cl aCc eS5 b,'��' <br /> , U <br /> s Fee Rec: I"`- <br /> Ec Check#: <br /> v <br /> m <br /> p,Q A <br /> Date of staff site visit: I.o15/02./ Initials of s' , visit staff: O 7 <br /> 1V/Cif'J <br /> APPROVED BY LAND SERVICES OFFICIAL: ���_ /� ;-" / DATE: {{�..//// . � <br /> IThil <br /> UPON APPROVAL: APPLICANrMUST POST COPY OFa W C <br /> --I <br /> ll <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ' a,c N huh <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 g <br /> a <br /> b <br />