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• y <br /> LAND USE PERMIT APPLICATION - Burnett County, WI <br /> Applicant Complete All Sections Below This Line 0' <br /> Permit Types and Fees:(Please,check appropriate boxes)', G <br /> Dwelling/Principal Structure $300 'Addition/Alteration to Dwelling/Principal Structure $200 d 1.3, <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure _$200 NeNV1 <br /> �cessory Structure(Garage,Shed,etc.) $150 / Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 .,p q <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> ..k, <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures _$350 <br /> Filling/Grading $150 Boathouse $500 r <br /> Six Month Camping Unit(One Per Year) ° <br /> p g $100 Permit Extension(1 Year Extension-Allowed Once) $100 % <br /> *NOTE:After-the-fact permits(permit squired 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. <br /> *Items notlisted above will be treated as accessory structures,such as:pergolas,landscaping,etc. ro Dili) <br /> ���+ o 5, <br /> Property Owner's Name: v r ckn k ntS,On z <br /> �,�,�� f -�_ p o <br /> Property Owner's Mailing Address: '_7® Psi lA E 1.? rki - atllbant WI /o <br /> p pa..--)0 r Qlu� �r j 1 City tate Zip i <br /> Property Site Address: if C-i'1thVct(\ ,--. ci- ?30 ,-nom <br /> :::::'.Contact's Telephone Number: .71 — aaa —go? <br /> o <br /> E <br /> Contact's Email: 3ran4-ame.soo 61 5010, f J-(mom e <br /> Legal Description of Property: I C5fkl V 4 T Li 7 <br /> 9 �J o . <br /> Section#: t Town#: `°N Range#: )& W Town of: Oet .(ar? A . <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* O <br /> Tax ID#(1-5 digit number;found on tax statement): 3;00 1 <br /> Proposed Use of Structure/ ddition: DI skiO <br /> IIPP7 CA <br /> Anticipated Start Date: 'II '.i�O't)r- (Hole/Cabin;Commercial Business:Bedroom;Deck:etc.) � o w' <br /> Building Contractor: _e1" bt.t"4. Sewer Installer: flO V.+` <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: -kc <br /> IM <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 2 <br /> home additions,and bunkho set.** <br /> 9oi&- J 5e C� , ,,.... t I <br /> 3 Lean�o sero 5dtec_�� needs kIJ -tpeaki-1 <br /> x Fee Rec: L5-1A- <br /> ty, 1?./' , Check#: ece, <br /> Date of staff site visit: 0067A71Initialso site visi +,0 a _ <br /> APPROVED BY LAND SERVICES OFFICIAL: . , , 4_"46,--1-7f DATE: /227/a� < �' <br /> c4 mUui <br /> UPON APPROVAL: APPLICAN ' MUST POST COPY OF 4 a tos0 <br /> mG co <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° ZS e a, TE <br /> Transcendent: Page 1 of 4 m -0 7. o <br /> c m,.< r.s <br /> Laserfische: Burnett County,WI Land Use Application—Rev 12/2020 g '``' <br /> 511 <br /> u 3 <br /> 4 <br />