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• <br /> LAND USE PERMIT APPLICATION - Burnett County, WI a g <br /> cn <br /> Applicant Complete All Sections Below This Line CD N <br /> Permit Types and Fees:(Please,check appropriate boxes), ° SO <br /> :Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure .$200 i <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure _ <br /> ie ' $200 �o <br /> Accessory Structure(Garage etc.) $150 Addition/Alteration to Accessory Structure $150 a <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <, <br /> _ <br /> r I <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 0 , <br /> Filling/Grading $150 Boathouse $500 <br /> Permit Extension(1 Year Extension-Allowed Once) $100 ? F <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. g <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. �' g <br /> m. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> Property Owner's Name: ,_) 1/ /) ,0, ,i//) ry (-V� 1 -/2_4("i S in � '7 0 <br /> C� E. n , <br /> Property Owner's Mailing Address: 9 -/� ' JSP ,62O--" _s- c 'Jr(-/c✓ 4 - C4 A <br /> /� city State Zip �< - <br /> Property Site Address: '. 3 y.6-9 ,)574L,, /k,I 2.1 /?c' 5,../ ,?6,4 S ye,2 o <br /> Contact's Telephone Number: o <br /> p I v�y� - �c.S^�� s <br /> Contact's Email: --S 1 �� v 2g <' O C i %h� <br /> Legal Description of Property: / #i) S a) / 'Ucr iI- ' ?fie /) G pU a r A-- d <br /> Section#: 7 Town#: 2 k N Range#: 1 1) W Tovr;a'of: /. JC-r i�, r- iS f . c.J/1J�)`J 3 <br /> , . <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* J"s <br /> Tax ID#(1-5 digit number; found on tax statement): 1`' I' '''' <br /> Proposed Use of Structure/Addition: SAE-a/ J )i 04 /17/s1->" v, ,- //y/1ps4--A t, <br /> Anticipated Start Date: 4 - _' / , (Home/Cabin;Commercia : si . --,"m;Deck;etc.) <br /> Building Contractor: -A�,,( ts' Sewer Installer: `,t <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> **The applicant needs to contact their UDC Inspector to determine ifa permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkhouses.** <br /> 1nJ 1 <br /> © 0,0 5h9 i�J5/f /fle-a-'^;Met TjC D! MIAMI' = Fee Rec: 1. <br /> h ,�0�" ( h'� j'! /1.�, i>�G.'hC� ' 7, Check#: I 1-3L) <br /> Date of staff site visit: 5/3AAInitials of ite vis;ts f, r• ''F C h T` <br /> APPROVED BY LAND SERVICES OFFICIAL: , DATE:9 (! d <br /> UPON APPROVAL: APPLICAN . UST POST COPY OF a co <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z N-a ^' <br /> r n ~ <br /> .� 0 o C <br /> m c r., <br /> Page l of 5cD c <br /> Burnett County, WI Land Use Application-Rev 12/2021 < m <br /> m <br /> o <br /> . <br /> a <br /> 3 <br /> -o <br />