|
LAND USE PERMIT APPLICATION — Burnett County, WI a N
<br /> Applicant Complete All Sections Below This Line 0'
<br /> Permit Types and Fees:(Please,check appropriate boxes) Et. .),1
<br /> ADwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d `S
<br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,f.�"
<br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150
<br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 SS 0
<br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 „1
<br /> C)
<br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 \P °e k'
<br /> Filling/Grading $150 Boathouse $500 r
<br /> a ,
<br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 `
<br /> cn
<br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. =
<br /> cb
<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 /> a .
<br /> Property Owner's Name: – r, Ilk . " • z
<br /> o
<br /> Property Owner's Mailing Address: 1 1�s F r M c,v.---\--. \- 1.... ,Mh e,r I\h ti �ra .` f O
<br /> Cj65f
<br /> Atey ip �
<br /> Property Site Address: �, y � ��, 4 too 8 n
<br /> Contact's Telephone Number: r\ `"Z.,, – .Z,,_ \—, VA 1 `p AC/ o 1 _
<br /> � ~
<br /> rn
<br /> Contact's Email: ‘ v� e. r t l ) S p\ p, v C:.`.. \ `^ d
<br /> fo, 5 C4 'S p l/(L S
<br /> A Vro
<br /> Legal Description of Property: 0 /60j oc
<br /> Section#: 2:7 Town#: 3 N Range#: /6 W Town of: /' C.44/�0,1 o
<br /> 5'
<br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.*
<br /> d
<br /> Tax ID#(1-5 digit number; found on tax statement): \ `'
<br /> Proposed Use of Structure/Addition: ‘'''' -‘).-1 t\\,\,..,,��
<br /> Anticipated Start Date: (Home�'abin;Commercial Business;Bedroom;Deck;etc.)
<br /> Building Contractor: Sewer Installer:A k' tis `�
<br /> I
<br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY
<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 for any dwellings,dwelling additions,manufactured homes,manufactured z O
<br /> home additions,and bunkhouses.** t x S
<br /> Of-4, 140,,14',7 he_ IS 6iA4 exi'sAa9 po% bar'tt so f' s
<br /> ci, IA,uy roe IAA s n , w,A►k d 1
<br /> 0 u
<br /> r� s� 1 w 4,n oe_e u, e-0715
<br /> n 7 3 6e 'fr 2 +s f 5/1/1/- ,;rel til
<br /> �' �a� x Fee Rec.t�wr!i��J
<br /> 6th,0611)'1 � o Check#:�'3�
<br /> Er
<br /> Date of staff site visit: 6/9/20 Z Z- Initials of site visit staff: J'//, 5.-
<br /> APPROVED
<br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: /a�zr9ZZ < u
<br /> . .
<br /> .i
<br /> UPON APPROVAL: APPLICANT MUST POST COPY OF i re--.F>a2
<br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT �1 111111111111o mC.
<br /> >
<br /> '"gr a
<br /> Transcendent: - Page 1 of 4 m m
<br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020
<br /> mQD
<br /> 5,
<br />
|