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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) � V Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 E. <br /> W <br /> Commercial/Industrial Structure $300 •Addition/Alteration to Commercial/Industrial Structure $200 A ,O <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 NNW <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o <br /> r, Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r. <br /> Filling/Grading $150 Boathouse $500 o <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 to <br /> m <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. a <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. ro <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. t-. I <br /> 0 ' <br /> Property Owner's Name: N\i C h c( t! * Jean \ila ( + n 0 <br /> ,,, z <br /> oo <br /> Property Owner's Mailing Address: a--/a a5 S tat e, Road 35 e.bs -f 5 419 e- <br /> ', ,, \\ ' '1 City _ State -tp <br /> W <br /> Property Site Address: h I f a t i W 1 Id e r n ess ►2V Par" • f W-f - OD <br /> C H <br /> O r, <br /> Contact's Telephone Number: `715 -g( - gar-4„, Z c \ <br /> r ^� o <br /> Contact's Email: t _ h I t e.1-a.i I l ..)I Eck r nes5 hcst mCal I • CO✓r • <br /> Legal Description of Property: 1►l C 1LtCkt d o w� <br /> t <br /> _/ a <br /> �Section#: cd� Town#: 1 4� N Range#: ((,p W Town of: Ca� a� h(, . ,� \ <br /> o \V <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): 36a N <br /> Proposed Use of Structure/Addition: C cn P R r01k n d sir Li (`.f 0 re_ 1 x <br /> Anticipated Start Date: to)merit et tP HomeJCahin;Commercial Business;Bedroom;Deck;etc.) 1 p <br /> Building Contractor: Ai/A Sewer Installer: <br /> W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Q <br /> � �THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> (% rO//O 2 crl/ Con477`�oifS rtA-A.. CUi°- Z/--t° • z pv W <br /> • Fee Rec: 11,9ce <br /> • Check#: S 19 <br /> l6 � C-- r Date of staff site visit: Initials of site visit staff: › , <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3/ZE/702- r, - �j <br /> E. ►i`'u <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF v n <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o ^� <br /> w ^ O 2 <br /> Transcendent: - Page 1 of 4 ti <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 <br /> - <br /> c <br /> Y <br /> ro <br />