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LAND USE PERMIT APPLICATION — Burnett County, WI 5 g 7. b <br /> Applicant Complete All Sections Below This Line = `�"' <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) d M <br /> 41 ry <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 W r� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 J <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 <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 �. L <br /> Filling/Grading $150 Boathouse $500 5 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 r i <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-, g <br /> 0 <br /> Property Owner's Name: MIChQe1 "+" Jean \Aia I +ZI n o ns <br /> o • <br /> o <br /> g c r7 c 215 S ta+e- Road 35 f'bsicir 5 489 . - ' <br /> PropertyOwner's Mailing Address: <br /> City State ip C <br /> Property Site Address: WI-)i fe_t'a i I WI de r n cs c IRV Par Lc)-I- . z+.5. 4 <br /> o r2Contact's Telephone Number: r7 15 -R&L.. - 8 a'7(o <br /> 1,3 <br /> Contact's Email: WV)i Leta, I t i la.e ir 'less ICt 1'YICU ( . Co►'n <br /> Legal Description of Property: I it C kt.t C�C d o 00 �� <br /> Section#: 2j(A Town#: 1 40 N Range#: f t;0 W Town of: oat.I anaQ <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): L Q �6Z/ax ' cn <br /> Proposed Use of Structure/Addition: <br /> C.arngroLind S-E-ru o-f-OYe, W <br /> Anticipated Start Date: la)n-)edI cc`fre Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o 5 <br /> Building Contractor: A//A Sewer Installer: — -a <br /> lip <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY w <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> D f(/ot 4/7 ceptck4©em5 -Ei ctP- a/-/oa z . <br /> ( ..., w <br /> .71 Fee Rec: /2, .ZD <br /> y Check#: k/25- <br /> 'A, <br /> Date of staff site visit �— I '7 `� A C) Ini ' Is of site visit L t '� Cm <br /> r <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3/Z7/ z. / <br /> M <br /> y -�° n <br /> UPON APPROVAL: APP CANT MUST POST COP OF <br /> • <br /> do*; fir <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 00 N <br /> G2 <br /> Transcendent: - Page 1 of 4 m <br /> ffl <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 <br /> C� <br /> 6 <br /> ro <br />