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• ' LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 .4 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 r , <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 NI g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o Q b <br /> /'`4 Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 QJ <br /> • <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 lv <br /> • <br /> *NOTE:After-the-fact permits(permit aquired 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 not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r 5. <br /> r z <br /> Property Owner's Name: M t c.h c c I `t� t'an \/V l I +-Z-I Yl cj -1-10 <br /> E. <br /> ' 1 lI -� <br /> Property Owner's Mailing Address: cE`7 a as J ta.-1-e "Floor! 35 L�eb5-tc - WI- `J L 934 <br /> , , \\ City / w cn <br /> r)W Property Site Address: h 1 rota t 1 �1 Id e r n eS-S R ) P ar �_� MI 4 <br /> c, <br /> Contact's Telephone Number: `7 15 (r(n d'7c,,, . a <br /> Contact's Email: wh"11 t Ca e t I LU 1 Ic1-C( i7e55 @.h mcu I . CAD►Th , h .' <br /> • <br /> Legal Description of Property: In e kl.t C`t cI 1 <br /> Section#: ?j c9\ Town#: 1 1-4C N Range#: ((p W Town of: Oak.1 a r c( d N <br /> *Attach additional page if needed for 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): t'- 7 , - 3‘'Z93 cip <br /> x <br /> Proposed Use of Structure/Addition: CCc n.p Y O Ll r ct sly() t^-I---L7 ire._ o x <br /> Anticipated Start Date: ►r")med.t a t'P, Home/Cabin;Commercial Business;Bedroom;Deck;etc.) t N a 5 <br /> Building Contractor: /V'/A Sewer Installer: — ; <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: A N <br /> 0 F//ot:) 4// cepc% ifs - Cu I°- 2-1` I . Z w <br /> H Fee Rec:1Z5O° <br /> N Check#: 0'1"IS <br /> Date of staff site visit: 6 — l 1 i d�O Initials of site visit staff:p RV' y <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3//2 Z7 . t l J <br /> co <br /> Nil <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT .F , 115 <br /> Oo 0 <br /> CD C <br /> Transcendent: - Page 1 of 4 m <br /> Q <br /> Laserfische: - Burnett County, WI Land Use Application -Rev 1/2020 �.CD <br /> 1w <br /> ro <br />