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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> Applicant Complete All Sections Below This Line t <br /> g f - <br /> Permit Types and Fees:(Please,check appropriate boxes) Y Ui <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ''� U'` <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 C <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 /> p M <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> 7, Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <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. -a <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. i-, J <br /> o — L. <br /> z <br /> Property Owner's Name: M 1 C h CI e,1 `4" .J tor. \.AJQ. I +Z 1 Yl o <br /> m <br /> Property Owner's Mailing Address: r]c- aJ tat e trio ad 35 Webs�tcii- VI. 5 409 a <br /> rr ,, \\ City <br /> Property Site Address: W 1 to 1 I 61 d t Ir (i ess L1 Par riM _ <br /> o 7 Q <br /> Contact's Telephone Number: `7 15 -f'(e-(n - S a'7io a <br /> Contact's Email: C ( ne55 @,hot mcu I . Co a-1 -O <br /> Legal Description of Property: In C 1(t d C Ci N Q <br /> S <br /> Section#: 3)) -)., Town#: 1-4O N Range#: j(e) W Town of: oak<la h G w N <br /> g <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* R -� <br /> '- <br /> Tax ID#(1-5 digit number; found on tax statement): _, 9 3‘a? 3 <br /> Proposed Use of Structure/Addition: C_et_rnp et r D Li tad S{"r( } ( o Ire o ,, <br /> W f H <br /> Anticipated Start Date: lr' (neat ci-1--e, ' Honte/Capin;Commercial Business;Bedroom;Deck;etc.) I N 3 p <br /> Building Contractor: /�//A Sewer Installer: — -3 0 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY W <br /> A <br /> IIN <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: O <br /> D r"o/l ow Q// coa e y s - ,, Gup"a l- O r z A <br /> Q ft/ ot,, dlv ke p toA4f is ems- uµ '/ /'f is ree'/I^e- / <br /> w <br /> or ref/act/ w)0 s% 7.t P, mc,e,T s/z e- //tA, ► 7-5 <br /> H Fee Rec:/2-, SbO <br /> N Check#: '3/?3 <br /> Date of staff site visit: 6 ''t, -- GO`0 Initials of site visit staff: 1)L �\ a o t <br /> C <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: .0 ‘ZV = Nil <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF N <br /> n N:- Y u Y <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT "r 0 <br /> w Z <br /> Transcendent: - m § t��1 <br /> Page 1 of 4 u ull <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 ( l <br /> m \` JJ <br /> a <br /> ti <br /> Y <br />