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LAND USE PERMIT APPLICATION — Burnett County, WI al <br /> 'A <br /> Applicant Complete All Sections Below This Line <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) F ,..) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> F <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 q <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n Q <br /> . Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> /1 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 d IL <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. i-. <br /> / 0 <br /> Property Owner's Name: NA(C h C e.I -4-- .J�'_QY1 Wa. 14-Z l n -„ p <br /> Property Owner's Mailing Address: c a c) cd-5 5 t e P)e,ad 35 Webs-tic I- 5 L 9 <br /> 7 3-a <br /> ' , \ City e E <br /> Property Site Address: L.-0H I f t t a I I W I Id t r n ess U Par t- _3� <br /> O y <br /> Contact's Telephone Number: `-1 15 (c(t, a'7 .,,, n. �� <br /> Contact's Email: �, h I t e tali I / W I ICI ( hc5S h t5t Mai I I . CO►1'1 v <br /> Legal Description of Property: I I 1 C.\IA Cl t CI o 00 <br /> Section#: 3 c Town#: 1 1-40 N Range#: ((p W Town of: C..)(a_ 1a n(f o N '1k <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): /3 8 3 l0 Z/ 3 <br /> Proposed Use of Structure/Addition: C0.rn.D c, Y-p tt n d 51-rjj (`-F U✓e_ F <br /> Anticipated Start Date: 10)m ect(a-t e Home/Cabin;Commercial Business;Bedroom;Deck;etc.) , ° 5Building Contractor: /\//A Sewer Installer: — -3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 0'1 A W <br /> THIS PERMIT IS SUBJECT TO� ALL CONDITIONS LISTED BELOW: GN <br /> O /olloW a Ill Co a /_c/;4;9/5 l t.✓1 C U, -a/-/Q o z <br /> H Fee Rec: IZ. 5v <br /> N Check#: g <br /> Ir p ° <br /> Date of staff site visit: �� r l G Initials of site visit staff: bI- /ry`' r <br /> 7,.› <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 0g7OZ� �`'.L <br /> v <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF O a <br /> 3 -� <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CD <br /> o N ttu <br /> IV <br /> Transcendent: - Page 1 of 4 , v.< Q <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 0 R1 <br /> b <br /> LL J <br />