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LAND USE PERMIT APPLICATION — Burnett County, WI a- r <br /> a b N <br /> Applicant Complete All Sections Below This Line ro �� <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) f,, <br /> ro <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> F <br /> Accessory Structure(Garage,Shed,etc.) $150 ,Addition/Alteration to Accessory Structure $150 J <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C) <br /> / Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o <br /> /' Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r <br /> ' Filling/Grading $150 Boathouse $500 g <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <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. t-. g <br /> Property Owner's Name: N\1 c h'10 t I `+- Sian \.ila I -I'Z I n <br /> f 'lI � .� <br /> o <br /> Property Owner's Mailing Address: a(-1 ri S ta+e, Road 35 Webs-Y VI_ 5 1-I-09— <br /> W <br /> ` ` City .. N <br /> Property Site Address: h i f tat 1 1,�i Id e r n ess IZV Par -t--A `i(e C <br /> < _ E <br /> 0 ,,,, <br /> Contact's Telephone Number: `i 15 - '(cx, a'7So a. i <br /> Contact's Email: L.L)V11 f 2.tai i U)i 1Cl-e.tr.r e$5 @,001- ()let 1 . Co al <br /> 51 <br /> Legal Description of Property: In C I t,t Ck ke CA N <br /> ao ill� <br /> Section#: 2)C:k Town#: 1 40 N Range#: f Co W Town of: O(lK l Q in c( d <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): /.38 9 5 36 Z93 ~ <br /> cn <br /> Proposed Use of Structure/Addition: Larry clik rO Lt.f d s-f-ru (`_*0 re t W F x <br /> Anticipated Start Date: to)meCdI cut-e Home/Cabin;Commercial Business;Bedroom;Deck;etc.) a d <br /> Building Contractor: A//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 /> /4/..) cr/� ciPki ocZ4ioNS iA" CUP-Z/--/0. z s N <br /> p`�n1 <br /> Fee Rec: /L,ADD <br /> Check#: 91?if <br /> �� j-7 DLI M2- rn <br /> Date of staff site visi( '� Oct 0 lni ' Is of site visit f: .,r, <br /> /l U <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 07/00 Z T <br /> r— <br /> na X d <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF _@ k n. <br /> J" C7 a U lJ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o c N r� <br /> Transcendent: Page 1 of ` I <br /> r co <br /> 4 ( 3 <br /> Laserfische: - Burnett County, WI Land Use Application-Rev 1/2020 a <br /> u <br /> te <br /> b <br />