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• LAND USE PERMIT APPLICATION —Burnett County, WI ro r <br /> a b <br /> Applicant Complete All Sections Below This Line 5 c <br /> Permit Types and Fees:(Please,check appropriate boxes) i <br /> Dwelling/Principal Structure ° <br /> $300 Addition/Alteration to Dwelling/Principal Structure $200 <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 (D <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <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 P C6 <br /> 2 <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. -v fi\c- <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. t- g <br /> z <br /> Property Owner's Name: MIc.hQeI ` " Sean VfaI +Z.In p <br /> 10 <br /> Property Owner's Mailing Address: a r7 c 5 S±O±e R►o ad 35 Webs-tc . VI_ 5 4093-a° <br /> // ,, City n <br /> Property Site Address: W) ► to 1 I 1 der nesS IQV Par -t <br /> Contact's Telephone Number: rJ 15 -Sc( (o - e a 7(.:, <br /> ° <br /> 0 <br /> Contact's Email: W h 1 f eta 1 I Lt..)I IG`I-e r neS5 I hCS1.M Cu I • Co►Y.\ <br /> � <br /> ,Legal Description of Property: 1►l C I t,t Ck Cl <br /> Section#: c� Town#: 1 40 N Range#: ((p W Town of: C(IK I a 17 5. <br /> d <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): -71/43 26 / 3 Z 3 <br /> N <br /> Proposed Use of Structure/Addition: ca.rn p�ro Li rl �1,1 d a c-/-v re__ w k <br /> Anticipated Start Date: h(h(fled I C(-l- Hante/Cahin;Commercial Business;Bedroom;Deck;etc.) N p <br /> Building Contractor: /\//A Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Q <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: htz; <br /> 19fi/�0� 4�/ C-on i 7fieit iM CU�"ZI-/O. z <br /> G\ <br /> 7 Fee Rec: /ZiSZ <br /> N Check#: $/9S' <br /> l <br /> Date of staff site visit: -! _ ov�D Initials of site visit staff: o <br /> rt <br /> ti r- <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3 z Ze Z K Q <br /> UPON APPROVAL: APP .CANT MUST POST COPY OF ' z co a 0 <br /> 0 CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT - o 0 'NI <br /> °,< o <br /> ` Q <br /> Transcendent: - Page 1 of 4 m <br /> RI <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 ' .. <br /> LC:::3J <br /> H <br /> Y <br /> ro <br />