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• <br /> LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line o c z. CD N <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 -t_ O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 .- ' <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 $' 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 g" s <br /> Filling/Grading $150 Boathouse $500 c4 <br /> A, <br /> Permit Extension(1 Year Extension-Allowed Once) $100 E. <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. S' .. '% <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o L <br /> *11 <br /> Property Owner's Name: � <br /> �. - .4 F ►e6)n -j--- _ -e y �°a. <br /> Property Owner's Mailing Address: d 7SQ -SA rld (...4.u. Sill I4-L ) Webi i(11ZZAkcK = k' t <br /> City StateZip 5 <br /> Property Site Address: a.7 7(' Get - S16 J ed > �,)e YDS{f t L- I.L S��t 3 a. <br /> , <br /> to I <br /> Contact's Telephone Number: —o -/ a U d <br /> Contact's Email: \(�h'ei�e hS( C I'Y1a ! 1 • co z <br /> v L(4 /I p <br /> Yr a5 pa05. ( rmeri Loi-I! clear. a. <br /> Legal Description of Property: -r- . 1OCM F. <br /> Section#: !.Jo18 Town#:�4()Iv N Range#: RI " W Town of: :73 CA SO h g, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): J 9-3/0 ' o <br /> Proposed Use of Structure/Addition: �j{-)Pd : �-I 7�C Ce �C. /0 c O )k 7 h Q T, � <br /> 5 <br /> Anticipated Start Date: (0— I 2-2-- (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) , �. <br /> Building Contractor: �1rt 1^tl I e IZ. l 1 1 01 I ri) Sewer Installer: L2 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> Po <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 <br /> ho e additions,and bunkh/o�yyses. <br /> 1'h ee-F— 4 U SES , <br /> No. -. ;( /VA 01001 )444-64;0, //� <br /> 2 Fee Rec: 1501) <br /> y Check#: i i q2'' <br /> 14Z-. <br /> v <br /> '? rn <br /> Date of staff site visit: Li'!I ? Initials of site visit t:ff: > <br /> i %, z <br /> APPROVED BY LAND SERVICES OFFICIAL: Af ' �, DATE: /AWd'/` m <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a W <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 1 CC' 4a <br /> Page 1 of 57< <br /> � <br /> Burnett County,WI Land Use Application-Rev 12/2021 s <br /> v a � <br /> a <br /> 3 <br />