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4 LAND USE PERMIT APPLICATION — Burnett County, WI - g <br /> Applicant Complete All Sections Below This Line 0 ' � <br /> 0 <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ,J <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o <br /> /' Q . , <br /> , Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> ' Filling/Grading $150 Boathouse $500 � 1 <br /> Six Month Camping Unit(One Per Year) _$100 Permit Extension(1 Year Extension-Allowed Once) $100 �, <br /> w <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. o <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. i-- 1 <br /> Property Owner's Name: M 1 C 1110 e.I -+- .J ea_n \Aft ( -I-7..1 nc, o ` <br /> • <br /> Property Owner's Mailing Address: c)r],)as S tO.-}" f" 10 act 35 We b5lc.v Y L 5 4�J 9j�8°- 1 <br /> \ I , \ City tate E <br /> Property Site Address: LO h i f�'t a t I W 1 id e 1r n eSS toAl Par -t -II 5 K lb <br /> Contact's Telephone Number: ` 7 15 -b& c> •- S a-1(0 \ ,,` a 7 <br /> \�" o I <br /> Contact's Email: L.,..,)h-)t t e tcu t u�I I CI t ir V e55 ' lnO r ()lag I • CO►'11 7D ‘,1 <br /> Legal Description of Property: 1 t1 C.ILA C)t'C/ N ao <br /> o <br /> Section#: �j Town#: 1 1—}c N Range#: j(p W Town of: nrax_I(a n(f o <br /> *Attach additional page if needed fbr lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): 2 36 Z/ta 3 <br /> Proposed Use of Structure/Addition: C.Ck_rh.p C' o L( n C ,sly 0C -1-1)ire_ W F x <br /> Anticipated Start Date: )r t1(rledl CZt-(? `11Home/Capin;Commercial Business;Bedroom;Deck;etc.) \"3 N5Building Contractor: Ai/A Sewer Installer: Hi <br /> czs <br /> .Q <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS, LISTED BELOW: <br /> C) Follett) C,// �AchVIbi4S y"1,.. CUD"/�`Zi - /C, z, <br /> .1 Fee Rec: /2/S <br /> A. N Check#: 2/92' <br /> Date of staff site visit: , 1.1 a�© Initials of site visit staff: 1--- ► \ <br /> J h�.J <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3�7/ZdL� x w <br /> _0MI <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF F, g g f <br /> , <br /> OW <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 2 0 N o <br /> �w � 1 C <br /> Transcendent: - Page 1 of 4 n -.< <br /> Laserfische: - Burnett County, WI Land Use Application -Rev 1/2020 n <br /> c JJ <br /> Y <br /> ro <br />