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LL-111U 1.33r r�1V1V111 HrrL1l.1-v1Ilill — DUI-llell county, vv1 cr <br /> Applicant Complete All Sections Below This Line Fn. —.Q. <br /> Permit Types and Fees:(Please,check appropriate boxes) F 01 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 qq <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> I• Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r-, <br /> / Filling/Grading $150 Boathouse $500 g (.----7- <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 c' <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. AA....*Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r, 9 <br /> r <br /> Z CI <br /> Property Owner's Name: N\LC__, 0 C.( "� •J t'(_Yl \/�/Q I +Z( n G ° 4) <br /> o` <br /> Property Owner's Mailing Address: cE r7 15 tGlf e ?load 35 (.l)e.bs-tcv VI 5 40 13i <br /> liN <br /> V City ate E <br /> Property Site Address: (_,L)hi1-{tta t I �V1 id Ir ►less t�L� Par' `1_D <br /> o <br /> �' ,- <br /> Contact's Telephone Number: `]I5 - (cCo - 8 a'"--4,,, ,, <br /> 'L�?�/�' � N a VD <br /> o <br /> Contact's Email: t h I t LtCu ) LU I IC - ( r e5S @�.0Ofi r nCU 1 . CD ►'Y'\ r, i, ^ <br /> Legal Description of Property: I rl C I t t CI t'CI N <br /> 0 uo <br /> 0 <br /> Section#: 3()\ Town#: {I-}O N Range#: J(a W Town of: on_K I n n G{ o <br /> o <br /> *Attach additional page iJ needed lbr 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): 49)` ' 36 Zp 3 <br /> o <br /> Proposed Use of Structure/Addition: (� O t 11{7 r0 Ll Yl d Si rLi Cs+U re_ zt <br /> W x <br /> Anticipated Start Date: ►0 Meat CC-1--, Home/Cabin;Commercial Business;Bedroom;Deck;etc.) f.) = p <br /> Building Contractor: A//A Sewer Installer: — --1_ O <br /> AREA BELOW TillS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY O A <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: . <br /> Z fI/Iowe-C/ key �t Qf- is f4 to uI4�'/ I /S ve-p 1 <br /> er lc p/a Gem/ 14us 1e�14 /)1e,e - /ze 11''"‘,'7LS. <br /> Fee Rec: /2,5z,0 <br /> y Check#: 2r1? s' <br /> Date of staff site visi . Init' Is of site visit staff: bLit/L\r _ <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: -3/2-0-ea" <br /> I �� <br /> UPON APPROVAL: APPLICANT 'm a MUST POST COPY OF 3 o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT oIV <br /> Transcendent: - Page 1 of 4 .`` <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 1 NI <br /> v, <br />