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LAND USE PERMIT APPLICATION - Burnett County, WI - r <br /> b <br /> Applicant Complete All Sections Below This Line 5 <br /> Permit Types and Fees:(Please,check appropriate boxes) d W <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 vw W <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> 5 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> o <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 -- <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 v' 1 ,a ro <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. �2 <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 /> 0 <br /> Property Owner's Name: M f c l C e.14- i ean \.A/a. l +Z-I n o <br /> Property Owner's Mailing Address: ar7(-1 as S ta.�-e- "Road 35 Webs-Icy 5 t_Fg9-a , <br /> � `` � }. City State 'Sip ti <br /> W Property Site Address: h l f I Q. i I WI Id e r Hess IR 11. 1 <br /> Contact's Telephone Number: `7 15 -R(p(0 - e a r74o c <br /> \ o _a ,1 <br /> r <br /> Contact's Email: �h i t Cta i I U)► IC'1t it r)e5S @ hot Mal I . CO Yr\ 'P w <br /> aI <br /> Legal Description of Property: i n C 1 Lt Ck d N 00 <br /> Section#: :2-3 vk Town#: 1 40 N Range#: ((c, W Town of: ()aK 1 n a . N <br /> o <br /> t7i*Attach additional page if needed for lengthy description OR attach a�coop�y�oof�the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): -Ae Z i 3' &?3 <br /> Proposed Use of Structure/Addition: (=o (fl p�round S h' ( 1 c.-F L7 fit° .. W F k <br /> Anticipated Start Date: V meth c i—e Honte/Cahin;Commercial Business;Bedroom;Deck;etc.) i 1 ° p <br /> Building Contractor: It]/A Sewer Installer: -3 <br /> ` <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY '1 V <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Q N <br /> C% Pr/kit) a// CDitg7LIo/1C - t,•1 CUP—El—le'. z - Q <br /> lA <br /> 6\ <br /> H Fee Rec: IZj.S'O <br /> N Check#: �/q�' <br /> (- PAi✓_ <br /> Date of staff site visit:L� IL ^)QoZ b Initials o 'te visit staff: �� �� ' <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: Z-8/77-0a < Q <br /> v lo <br /> UPON APPROVAL: APP ICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o NJ <br /> CD <br /> Transcendent: - Page 1 of 4 c S 17111 <br /> Laserfische: Burnett County, WI Land Use Application —Rev 1/2020 n <br /> c <br /> ur <br /> ro <br />