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LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line o <br /> c. <br /> Permit Types and Fees:(Please,check appropriate boxes) 0 <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 /> a <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ro <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 < C <br /> n <br /> % Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o -� <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r^ ea, <br /> o S <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 /> z <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. ET ----. <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 g <br /> Property Owner's Name: `'l -n a o <br /> o <br /> P rh' NA el Jan \/�!Q I +ZI n� z <br /> Property Owner's Mailing Address: a r]c- as S faf e. Flo 35 Webs*.r Vv Z 5 1-"9 j e- r <br /> , City z n <br /> Property Site Address: Li)h l+f'to t 1 1 Id e r 1 CS S IQ V Par e ci <br /> N l <br /> Contact's Telephone Number: (715 -g(p(p - e a`7 , e a <br /> � <br /> Contact's Email: W�h I -1" <br /> eta <br /> t UC'�)I [ t.r 17to55 00 r CCU CO►11 N d <br /> Legal Description of Property: 1►`l C 1 Lt Ck CI o 00 <br /> 0 <br /> Section#: 3:9\ Town#: 1 140 N Range#: Rip W Town of: Oak<I a i c( o q 0,� <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attachta tax system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): 7 z?3 <br /> Proposed Use of Structure/Addition: Lan)q r0 n ct S{-ru t^f re_0 F x <br /> Anticipated Start Date: ►mrnedt cut-I--e ' Ll Home/Capin;Commercial Business;Bedroom;Deck;etc.) p <br /> Building Contractor: Ai A Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY i <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> O/o// ot// crag —rA;OS Awe COP- Zl-/& z Q <br /> hVv <br /> Fee Rec: /Z/$2 <br /> t7 Check#: /?g <br /> Date of staff site visit(-) D-45.2 Init' is of site visit ff: , <br /> �i <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: � Zr ZOZ '-3r —Nu <br /> UPON APPROVAL: APP ICANT MUST POST COPY OF 9, <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT a.:Transcendent: - Page 1 of 4 r <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 <br /> b <br />