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LAND USE PERMIT APPLICATION - Burnett County, WI a ro
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<br /> Applicant Complete All Sections Below This Line 5•
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<br /> Permit Types and Fees:(Please,check appropriate boxes)
<br /> X Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 O
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<br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 v1
<br /> Accessory Structure(Garage,Shed,etc.) ` $150 Addition/Alteration to Accessory Structure $150 O
<br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 CD
<br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250
<br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °
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<br /> Filling/Grading $150 Boathouse $500 r '(`"
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<br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100
<br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee.
<br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees.
<br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc.
<br /> Property Owner's Name: fi cav$Se t 1 w. //:qrn L,'4,-4,-,,,,i, .3R1.1
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<br /> PropertyOwner's Mailing Address: ti 7930 /Vopi1f Rrffl f- Laky teki lvt25- tel' le/1c9y} �
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<br /> Property Site Address: 7930 /Yore-!/,4,, r 1"A/r-0- RI G/e,/3S lei- ii-/i-- 4'sYi �' \N
<br /> Contact's Telephone Number: 7/6 77/ - 0'33 9' c
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<br /> Contact's Email: / L / / /,�,� Q ro
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<br /> Legal Description of Property: �(y�7 5�`� �--- V c P9' //
<br /> Section#: , Y. Town#: /0 N Range#: I''a W Town of: (rj- , ) c ro
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<br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d
<br /> Tax ID#(1-5 digit number;found on tax statement): 1 `,640/ �J 5-8-(95-8-(9Proposed Use of Structure/Addition: L// / m o tr
<br /> Anticipated Start Date: (Home Cabin;Commercial Business;Bedroom; eck;etc.) c x
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<br /> Building Contractor: S 8.//-- !f y 5$z// /,hJb,,.y r Sewer Installer: O,V I:,
<br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ' y .C.-?-)
<br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: N 0
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<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 %
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<br /> home additions,and bunkhouses.** z
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<br /> eX �1tq/r-e.R /k-i y/l ZZ• 7 Check#: e..4( -1-t-
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<br /> .51X 114014714 ��►� P P /
<br /> Oate of staff site visit: I 3/ 2-1Z.o � Initials of site visit staff: i/I //I I/ a
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<br /> APPROVED BY LAND SERVICES OFFICIAL: / �"C DATE: , _ 2-7 Z-04.
<br /> UPON APPROVAL: APPLICANT MUST POST COPY OF m;
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<br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT rn'
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<br /> Transcendent: - Page 1 of 4 .. r.a
<br /> Laserfische: - Burnett County, WI Land Use Application-Rev 12/2020Ell
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