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LAND USE PERMIT APPLICATION — Burnett County, WI a ro <br /> b Applicant Complete All Sections Below This Line 6 �,N <br /> a i-� <br /> Permit Types and Fees:(Please,check appropriate boxes) � <br /> UJ <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> 'J <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> F <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 n <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n P,-1 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> / Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 i- <br /> Filling/Grading $150 Boathouse $500 <br /> i° <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 i' S <br /> '= 16 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. E. <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-- <br /> Property Owner's Name: N\I c_h 0 e I ` -- ._}can \ila I +7.-i n „ <br /> Property Owner's Mailing Address: o)`7 t), S ta±e ( 1c ad 35 U b5-r V�' Z 9 5 4 <br /> '' ,, . \ City a e 1p 47. <br /> n„ <br /> Property Site Address: W`` Ll) <br /> hitetaIi 1 Idf'_ r 1)e,s- RL'S PQr Lo-t-- a/ <br /> Contact's Telephone Number: `7 j 5 -S(G(c) - 6 a'71, ----�\ d <br /> . a lk('� <br /> Contact's Email: 0.)h l f e.tc&1 / 1 ICI-('_(ne55 -Viol- rnCt.i I . COn l <br /> Legal Description of Property: 1 rl C\Lt C`t'CI o 00 <br /> Section#: 3 c9\ Town#: 1 t-}O N Range#: ((I W Town of: 0(1K la n '( A. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach taxta system property page.* R_ <br /> n <br /> Tax ID#(1-5 digit number; found on tax statement): �)� /6'(�/ JsvQ/ <br /> c o m <br /> Proposed Use of Structure/Addition: Earn p�1�p(,l tl G� �-{"rLl c-Fore_✓�� t V.1 <br /> Anticipated Start Date: ) 1 fl l(: (CtfiP., Home/Cahi,i;Commercial Business;Bedroom;Deck;etc.) �1 p <br /> Building Contractor: //i Sewer Installer: -- <br /> A WAREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: N <br /> 06/41A) 4// cenc; ;Er©'s -(- 10/A . cuP-zi -i.o, z % w <br /> .H Fee Rec: /2✓`70 <br /> Check#: $/pg' <br /> u <br /> Date of staff site visit:b — f ;20, E Initials of site visit staff: �f �� y <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: SE/?..e221/ ," L -el rz <br /> -- <br /> UPON APPROVAL: APP ICANT MUST POST COPY OF W a 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o - �_ <br /> N <br /> - <br /> Transcendent: - Page 1 of 4 M a) N i:: <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 1!l <br /> [ Ec .J <br />