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LAND USE PERMIT APPLICATION—Burnett County, WI . t~ <br /> Applicant Complete All Sections Below This Line 8 X) <br /> Permit Types and Fees:(Please,check appropriate boxes) p' <br /> k, <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 Kro <br /> 4 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ., <br /> XAccessory 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 /> C <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 t- t <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 N <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. p r <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 /> vv <br /> c--- _ g 3. f�1 <br /> Property Owner's Name: z )•-Cil ...i./ V1•'u4.ui J c �l <br /> 5Pro <br /> Property Owner's MailingAddress: &O / /t�Ar l 4u,_ - r:t e,'l _5-v0,266 a. <br /> 1 City State Zip o <br /> Property Site Address: 1 d <br /> X J[)C)l ;,;,,. � c c>,. � r+� 1 �� i..�,•(..., fc�`Z r5�y d53 7 1 n <br /> Contact's Telephone Number: 7/3.- 4//O -- c 7`/S . <br /> G <br /> Contact's Email: 64cuk.13y`h. e6rrw..1. C'd el o <br /> ,. <br /> Legal Description of Property: 5E �5 e t f c, - 3 2- /(-' <br /> 0 <br /> oa <br /> Section#: ,.),, Town#: 37 N Range#: / W Town of: T a L ts wk-� a <br /> *Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system propertyPa page.* 00 <br /> C7 <br /> 2 5. <br /> Tax ID#(1-5 digit number;found on tax statement): J 0 7o <br /> Proposed Use of Structure/Addition: 31-i-+R;.4.._ e6Z i.,lt,...;,, 0/0 L....A, EIC— `" <br /> Anticipated Start Date: yo <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) F �e <br /> Building Contractor: ,P :•1-1Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ;....,. 4 <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 O <br /> home additions,and bunkhouses.** t' %° <br /> if (neef- at( e 11 <br /> J}- t L n a. (�f -fic)n <br /> RI Fee Rec:MO-1)1) <br /> Check#: 71 8-(71 <br /> 531 a?- m <br /> Date of staff site visit: Initials of site visits z <br /> yore <br /> APPROVED BY LAND SERVICES OFFICIAL: illej/ DATE: �f.Gl�� rn <br /> �`—_1 <br /> UPON APPROVAL: APPLICANT 'ST POST COPY OF 111 <br /> ; a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° m <br /> 0 <br /> e — (rtjt <br /> Transcendent: Page 1 of 4n C <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 m 3• r Q <br /> o m <br /> , <br />