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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> 7. <br /> Applicant Complete All Sections Below This Line 3 T %%* 1 <br /> a ' <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 Dr ` <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ 0 <br /> F <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n C <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> 7- Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r. )) (- <br /> 0 <br /> Filling/Grading $150 Boathouse $500 6 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 v <br /> o <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. ' '-• <br /> 1 <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- i <br /> \ <br /> Property Owner's Name: M(C h 0 e I ` " i f'_'I (l_f1 Vila I +7-1 n ci , 2 ik <br /> Property Owner's Mailing Address: c� 3,c95 Jt(,L}'e_ "P)oad 35 Webs-tic VI 5499 a <br /> I ' V\ V City State •p n <br /> Property Site Address: W hi ffita 1 i Lk t Id e Ir n e5s ttU Par L�( -1- ,� ♦ <br /> Contact's Telephone Number: r-1 15 rr';'(,(L-, a r4o • a <br /> o ' <br /> Contact's Email: LATh1 t et Ck 1 / Up I iCit tr he55 l&ho Mai I . CO tIm —0 1 ik <br /> Legal Description of Property: I rl C\LA Cd r ell o w <br /> Section#:_,3 c9\ Town#: 1 1.40 N Range#: f Co W Town of: OaK I a n c( o N <br /> 0 <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): / <br /> ZZ 3 <br /> -1 H <br /> Proposed Use of Structure/Addition: CC�rn Cl,,pV-D Ll rl G1 S-�-Y'( 1 (`*L)re_ W F x <br /> Anticipated Start Date: l'�l(11 ect 1('(t ', • Home/Cahin;Commercial Business;Bedroom;Deck;etc.) (�} � o p <br /> Building Contractor:_)V'/A Sewer Installer: — " <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY w <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 61 <br /> c 0 Wfo10 q// colt hi 4olr S W] C U P- 2//D. z '° <br /> D <br /> w <br /> - Fee Rec: -- . v <br /> Check#: civ9e. <br /> 6 Date of staff site visit: — 16 - 6,9- O Initials of site visit staff: bL W— rr <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3/Zg/ZOZ-f m wC. Hil <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF g a 0 <br /> G 3 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <br /> Transcendent: - m ` <br /> Page 1 of 4 <br /> co <br /> Laserfische: - Burnett County, WI Land Use Application -Rev 1/2020 <br /> C�, J <br /> 6 <br /> ro <br />