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r. <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a g <br /> Applicant Complete All Sections Below This Line <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) F ...D <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 /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150nDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> XDriveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 — t%-.15— <br /> ' Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> , R <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. w <br /> q <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> ro <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r <br /> ° <br /> l z <br /> Property Owner's Name: M I C.Y 1 e I `"� J a Yl \ilaI + 1 f'1 '11 o ct <br /> 6 lb <br /> Property Owner's Mailing Address: c r7 a 45 S taf e P,oad 35 We.bs f V►' Z 5 t-F)g:3-a <br /> City State �'t. ��„ <br /> Property Site Address: L)h►f 'tat WI id e Y- ,i eSS le.V Par �" `'1(0 '' <br /> Contact's Telephone Number: '1 15 -fir,'(ern - 8.a`7(O <br /> o <br /> h I,h�rnCu I . Co G <br /> Contact's Email: l3 t 1 etG�t 1 u�I lC'I�d r���� —0 " N, <br /> Legal Description of Property: In C\Lt CI-cc/ N ° <br /> 0 °o OA <br /> Section#: c� Town#: 1-4O N Range#: f(p W Town of: CQ.K I all C{ uo p <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* R <br /> Tax ID#(1-5 digit number; found on tax statement): 1 7 4/ N /3e/ s 36 ;',J <br /> Proposed Use of Structure/Addition: C.0.1"n.p Q CO Li. n Cl SfrLi O*L)✓•e W -Ix <br /> �f11 Anticipated Start Date: ►oeJJ1 a tip Home/Cahin;Commercial Business;Bedroom;Deck;etc.) ^' n p <br /> Building Contractor: /VI/A Sewer Installer: — \" -1V <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY I:.THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> D f0i4 GO a/i copt >46. ,s GuP- ZI-/Qe x <br /> .- Fee Rec:12-5bO <br /> N Check#: $/ Q$ <br /> �M`, ' O <br /> Date of staff site visit:t^ 1 "DCa 6 Initials of site visit s f\ bu" \ -- y <br /> J rn I <br /> APPROVED BY LAND SERVICES OFFICIAL: ATE: 3/27/ 2V U <br /> m <br /> � a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OFrc' wco <br /> T C, 0SIGNED PERMIT APPLICATION IN PLAIN SIGHT z o Fill <br /> c N o <br /> Transcendent: - Page 1 of 4 n g <br /> -. N 1::: <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 ,; Jj <br /> re- <br /> c. <br /> Gh <br /> r <br /> �� �� <br /> ro <br />