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LAND USE PERMIT APPLICATION — Burnett County, WI cr <br /> Applicant Complete All Sections Below This Line y NN <br /> ' <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 �`-r <br /> Commercial/Industrial Structure $300 :Addition/Alteration to Commercial/Industrial Structure $200 W O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150NIP <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> / <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r. <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> 4 <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 /> eD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- <br /> q r 0 <br /> N <br /> Property Owner's Name: I C K O t I * ,J�'a n \l�l C I +7-i t'1 P 1 <br /> Property Owner's Mailing Address: a(7 a5 S tat e "Ko ad 35 Webs-Kr VI_ 5 L+07-3I <br /> ' . \ City tate B n <br /> Property Site Address: h i f "��t i I W 1 id c Ir eSS ►:LI va r "1"`'�' C' <br /> C y <br /> Contact's Telephone Number: 17 15 -R i - Ea-7‘., o _a <br /> Contact's Email: LA_ h I t etCL i 1 t.L)I IC it►r ne55 _h6r Mai I . CO n'1 g .. <br /> Legal Description of Property: In C 1 Lt.CI t o o 00 'p <br /> Section#: 3 c9 Town#: 1 I-40 N Range#: 1(1, W Town of: OOLK I a n CI o <br /> U. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax systemproperty page. <br /> Tax ID#(1-5 digit number; found on tax statement): �(o 2„c 3 o` <br /> p w <br /> Proposed Use of Structure/Addition: C..0.rn p�Y-D(,l n d `�{"rL.i C-1--0 try W � ;� <br /> Anticipated Start Date: )t'1'(11eJ1t cut-e, Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ° p <br /> Building Contractor: /\//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: <br /> C/ fW/p to ct// eeitci It o ifs cwiNI cU II- ZI- /O m z <br /> N k <br /> .. Fee Rec:/4 sro <br /> N Check#: S�9t� <br /> I '� • C <br /> Date of staff site visit: 'I�3 �� Initials of site visit staff: /iik` <br /> rri <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3 ZS ?�4Z nr <br /> <a <br /> UPON APPROVAL: APP ICANT MUST POST COPY OF -; t <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT no o N <br /> I Q <br /> Transcendent: - Page 1 of 4 <br /> ; R1 <br /> Laserfische: - Burnett County, WI Land Use Application-Rev 1/2020 <br /> Lc. J <br /> u, <br /> 4, <br />