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LAND USE PERMIT APPLICATION - Burnett County, WI a 52 <br /> r <br /> b <br /> Applicant Complete All Sections Below This Line 5 <br /> aa. <br /> Permit Types and Fees:(Please,check appropriate boxes) a �t <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 'c .J <br /> Commercial/Industrial Structure $300 i—Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ro <br /> R <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 c) <br /> - , <br /> 7` 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) $100 v' <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. P <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- , <br /> 0 <br /> Property Owner's Name: NA IC K CI e,I `4- .J-earl \.Akl 14-Z I Yl ci -, P Fr_ <br /> Property Owner's Mailing Address: a r],i a5 S tci±e_ -Plc ad 35 (A)eb5-cr W .9 ,e- I. <br /> II ,, \\ ' • � City tate Zip = �; <br /> Property Site Address: W h I f to I I W 1 id e r n eSS ��I Par I-01-1-1 ,3Z <br /> o N <br /> Contact's Telephone Number: 1-1 15 -g(cL, - 6 a e-ic, I E. , <br /> Contact's Email: u041 I t eta I i�l I (C'I V neSS hofi rY)cu Co/I 1 <br /> 3� <br /> Legal Description of Property: 1 r1 C 1l t CI t'CI o go i <br /> Section#: 3 9 Town#: 1 yo N Range#: ((p W Town of: ((aa_K I an C'l -. N <br /> o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. q. <br /> Tax ID#(1-5 digit number; found on tax statement):_ 36 zQ/ 2✓ I. <br /> cn <br /> Proposed Use of Structure/Addition: Carr C f O Lt rd S{rLI I^ f ore.. WV x <br /> Anticipated Start Date: lr T (nect(Ct 1-f' Home/Cabin;Commercial Business;Bedroom;Deck;etc.) t N ° 5 <br /> Building Contractor: /�qf1 Sewer Installer: — -3 <br /> lf,11, <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY W <br /> THIS PERMIT IS <br /> SUBJECT TO ALL CONDITIONS LISTED BELOW: 6N. <br /> D FelIcW ctil C.etAc ;4d/r5 ,,, Gu P- /DO <br /> w <br /> H Fee Rec: I Z,..SVO <br /> 7, Check#: yl?$' <br /> r1 • 0 <br /> Date of staff site visit:6-It, - © � Initials of site visit staff: �I-- / , • <br /> cm <br /> 2 C <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: ! S 20ZY <br /> < Q <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF r, < ° <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 7 (c ^' o <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 R 2 _ J ) <br /> \` <br /> ro <br />