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LAND USE PERMIT APPLICATION — Burnett County, WI r <br /> a so <br /> Applicant Complete All Sections Below This Line 5 N <br /> Permit Types and Fees:(Please,check appropriate boxes) o <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 n <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 '4 rD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> F. <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1y)Structures $350 r <br /> ' Filling/Grading $150 Boathouse $500 2 <br /> Six Month Camping Unit(One Per Year) $100 _Permit Extension(1 Year Extension-Allowed Once) _$100 <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. -o <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r <br /> Z <br /> Property Owner's Name: i L LLC_( c I -I- -J Can \ila I f Z-_Ln c1� 2 <br /> .n 2 <br /> Property Owner's Mailing Address: c fb. ±0 1-E. 2ioacl 35 eb,5-tcv 15 L[09 ° <br /> !! City n <br /> Property Site Address: LL,I-)i L-- 1 ( t l 1 C.1 e I ,i eSS ►R V Peir N z S <br /> ^- <br /> Contact's Telephone Number: '7 15 - (`Co - S a'-7k -� <br /> Contact's Email: L i t c 1 C&1 / ll,' i ICI C F- Y7eSS @t hofi()ICU I . Co n'1 <br /> Legal Description of Property: I t l C It.tCI c Cl N , <br /> 8 <br /> Section#:J_`-i.`Town#: 1 1-{(D N Range#: f(y) (W Town of: ( K I(1ri a r� N <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#(I-5 digit number; found on tax statement): -/-3 3 13 <br /> L cA <br /> Proposed Use of Structure/Addition: C'.O.- n p Ct F" D Li nd 5 f r L) (`-U lit° l-` <br /> Anticipated Start Date:_(t"t)(rl('(,t1 a-(-(' Hone/Cabin;Conunercial Business;Bedroom;Deck;etc.) (t <br /> \v o j <br /> Building Contractor: Ai ir\ Sewer Installer: I '� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY A W <br /> �T/HIIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: , N <br /> 0 I fJ/% Q 1( 600 C/5L1h/1� -c yv1 C U IP-Z/'/�o x W <br /> C) Alleoe/ 4 =e 09AQ/- / s 1,iA1'/ /7 / <br /> reparl^e or eel <br /> A&e f'1POI- VXeM fro S/Z'� s <br /> //tom i`/ ' * = Fee Rec:04 ..ram <br /> Check#: la..reg. <br /> �h <br /> Date of staff site visit: VVa b Initials of site visit staff: IL lidlY-- o <br /> y 2 C"'7 <br /> r <br /> APPROVED BY LAND SERVICES OFFICIAL: ATE: 3 Z7 Z01 rr a <br /> UPON APPROVAL.: APP ICANT MUST POST COPY OF v? -4 0 <br /> ym � Guy <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT c0 o <br /> r /.1S <br /> Transcendent: Page 1 of 4 'pi Ja <br /> Laserfische: - Burnett County, WI Land Use Application-Rev 1/2020 - <br /> Lc:::::jJ <br /> Y <br /> '9 <br />