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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line = ro <br /> Permit Types and Fees:(Please,check appropriate boxes) °- <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure _$200 d V,I <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200U <br /> V Accessory Structure Gar ag 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 V <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1y)Structures $350 o <br /> Filling/Grading $150 Boathouse $500 r p <br /> 0 <br /> _ <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> I*NOTE:After-the-fact permits(permit aqui red 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. rTS <br /> I*Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: �'Z�el) (C�'} cZ©v/1„,,,rA.) o z `, <br /> P I <br /> Property Owner's Mailing Address: 7/ 23 ,O/G5✓n e c7 Oce[AJ bury ce b 3 a o <br /> City State Zip a <br /> Property Site Address: -7(6 g-3 P/ 5/3-e /Ue i0".v b of y 5'q fs,3 6 . <br /> cn <br /> Contact's Telephone Number: to - S(C) —'i :).(3— '3 1 <br /> a. <br /> Contact's Email: r bo 2/'g 1/4N 3cL/i 9.}?') c. / ( - c-'G 11 55 d <br /> ro <br /> Legal Description of Property: Lei"- / <br /> Section#: d Town#: L.( 0 N Range#: `(9 W Town of: 0 fit( L. u'a <br /> ro <br /> *Attach additional page i needed for lengthy description OR attach a copyof the deed OR attach tax system property page.* <br /> d <br /> Tax ID#(1-5 digit number; found on tax statement): 3 3 6 4 <br /> Proposed Use of Structure/addition: G'i t `-7,33.2 i-3 <br /> Anticipated Start Dattel/5/ 22 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o , <br /> Building Contractor: JqN S5 2N L L C- Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> Cly <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <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 foany dwellings,dwelling additions, manufactured homes, manufactured Irz —C4 <br /> home additions,and bunkhouses.** z <br /> pole eV a.It Se-kb cb.S <br /> dpfUo-C- htkm �ubt .1c)►1 <br /> x Fee Rec: l ` <br /> 14 Check#:-7/ /49 <br /> o <br /> Date of staff site visit: 17/,2 a Initials of site visit s aff: L. ' <br /> / Air' �=-� <br /> m, w <br /> APPROVED BY LAND SERVICES OFFICIAL: , ,;OW DATE: 6/651 a07 ^ c U ul <br /> UPON APPROVAL: APPLICANT M ST POST COPY OF a ? o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 h <br /> w d <br /> Transcendent: - Page 1 of 4 N <br /> Laserfische: Burnett County, WI Land Use Application —Rev 12/2020 < -73 <br /> ��g.) <br /> a <br />