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r <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5� <br /> Permit Types and Fees:(Please,check appropriate boxes) p' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 (S ;; <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 .<< , <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 xJ [� <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. t <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. cD lb <br /> Property Owner's Name: L 11 Gle,- 1,1' f C ��Q� 14n tek61'4 Ene CJI .°r. - <br /> Property Owner's Mailing Address: 24415 Old ✓ WI I il`e;73 ° <br /> �^� City State Zip <br /> ., <br /> Property Site Address: ► ` 7255 Co. '' <br /> 2 <br /> Contact's Telephone Number: 7 i 5 • 377 -g55-0 o T <br /> G <br /> 0 <br /> Contact's Email: 4 .._ => .o <br /> Co <br /> Legal Description of Property: �/�/o f� �.�J� <br /> {CiYI,0►r 0 on <br /> Section#: Town#: N Range#: W Town of: 0 <br /> 0' <br /> ao <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system propertyPa e.* <br /> p <br /> m. <br /> Tax ID#(1-5 digit number; found on tax statement): -4-I+ 3L ! 7 <br /> �ala� ( xIZ0 CA <br /> Proposed Use of Structure/Addition: ei 0H H <br /> Anticipated Start Date: ei-e,-a-� /,.,, (Home/Cabin;Commercial Business;Bedroom;Deck:etc.)( �-' H y°', <br /> Building Contractor: lftfCX5j � Wr p Sewer Installer:Nade,: k01W1 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY (51 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: (.1.\� <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to V , <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured Z \ <br /> home additions,and bunkhouses.** �' V <br /> ✓1ee� aII 5e-{-betbi,, 'o� <br /> a NA-- fir- hKk4444 i <br /> a '"d+ &)A x FeeRec: A/59(1° <br /> Check#: I/�/5 <br /> Date of staff site visit: °'1?-°'1?-� '1Q Initials site visits r ,� o <br /> ro <br /> o <br /> 81311 o <br /> APPROVED BY LAND SERVICES OFFICIAL: / /� DATE: < <br /> 1, I) <br /> ffd <br /> UPON APPROVAL: APPLICAN 'MUST POST COPY OFF W <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° y.C. "' ffli <br /> Transcendent: - Page 1 of 4 w S <br /> Laserfische: <br /> Burnett County, WI Land Use Application —Rev 12/2020 . 3 NJ <br /> C) D l <br /> b <br />