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LAND USE PERMIT APPLICATION — Burnett County, WI 6 g <br /> Applicant Complete All Sections Below This Line a <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) 0 G <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 `� .....1 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 <br /> ,/. Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o� , <br /> /`- Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 6. <br /> / Filling/Grading $150 Boathouse $500 w <br /> yft <br /> Six Month Camping Unit(One Per Year) _ $100 Permit Extension(1 Year Extension-Allowed Once) $100 0 V <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. <br /> o <br /> Property Owner's Name: M I a l Q e.i * ta-rl a 1 +Z i lrl ci .�, o '♦ <br /> Property Owner's Mailing Address: a'7 c as v ta+E'_ Ro aU 35 (,1)eb5-ler v Z S 484 ° <br /> ' , \ '' ''A\ City tate 6. <br /> W <br /> Property Site Address: h I f fia i I U)1 �d e r n eS.s ►2v Par -I-' `, <br /> 0 N 1- <br /> Contact's Telephone Number: Pi 15 -g(o(0 - ea 17(o rl_ a <br /> C7 ii <br /> Contact's Email: LOh l t eta, I LL)I Id-C tr Y)c$5 g IC t(Y' CU I . Co rY1 4 <br /> Legal Description of Property: I l CIUCkta o 00 <br /> 6) <br /> Section#: j k Town#: 1 4Q N Range#: J(o W Town of: C)a K) x r) d N <br /> *Attach additional page if needed for lengthy description OR attach a copy of thedeed_OR attach tax system property page.* '� <br /> ,Lsf <br /> Tax ID#(1-5 digit number; found on tax statement): 9 / 3 e Z / .3 <br /> Proposed Use of Structure/Addition: r 0�cn D Lt nd S�rla (`f L1✓e. W F x <br /> Anticipated Start Date: I)rnmedICt-1-e YHome/Cahin;Commercial Business;Bedroom;Deck;etc.) Iv ' p <br /> Building Contractor: /\//A Sewer Installer: — I <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> (o/lo l.J a// cc A cr7 7%)9"1 S —7-t tA"'1 C-I1/9'2-f—/d m z N <br /> pz S LJ <br /> N (I., <br /> H Fee Rec: /Z,sOO <br /> Check#: 9/9k <br /> /t \�Date of staff site vi / a0)O Initi Is of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3,�/ZOZ./ � ` <br /> U OF roc ). � <br /> UPON APPROVAL: APP LCANT MUST POST COPY �, <br /> hvg <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o oa N <br /> 0 <br /> z o i:-4Transcendent: - Page 1 of 4 , ` d <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 a 1!1 <br /> J <br /> 6 <br /> ro <br />