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• LAND USE PERMIT APPLICATION — Burnett County, WI 5 <br /> Applicant Complete All Sections Below This Line y <br /> a <br /> y —. <br /> Permit Types and Fees:(Please,check appropriate boxes) o vl <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 `'w IK <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 "Q n <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n 4 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> 6 . <br /> / , Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> ' Filling/Grading $150 Boathouse $500 • <br /> P <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 ns <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. -0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r.. <br /> Property Owner's Name: M I C.IT A C.I' `'f" -J ton \JV a. I +Z, n <br /> 0• 1 <br /> Property Owner's Mailing Address: c3`7 a 3 S tcd-e_ Rio ad 35 Lie bs-tci' it/Z 51 g 7 <br /> City State —Zip <br /> Property Site Address: LA) <br /> h 1 f t a I I Lk)t OO E i n e.ss RLt Par K _ <br /> C <br /> Contact's Telephone Number: `7 15 -R(c c' - 6 a'7Sv \ ° o R o . . <br /> Contact's Email: L,31')I t e.tck 1 / �..f..)I IC'`t tr tle55 OD hofi n'1CU I . CO►"1'1 --0ro <br /> Legal Description of Property: 1 n C\Lt CI C Cl N o� <br /> 7 <br /> Section#:?) .71, Town#: 1 HD N Range#: f(n W Town of: C)r K I a n r( o t�1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach taxi system proper!)'page.* -. <br /> Tax ID#(1-5 digit number; found on tax statement): 1^ Cc ' ' 3 6 Z l 3 cn <br /> Proposed Use of Structure/Addition: C.C). (1l_p CO Lt. 11 C 5 tYL1 r f t.)ire W x <br /> Anticipated Start Date: (t Yl Met[(CC-t'-e, Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ° p <br /> /' <br /> Building Contractor: //A Sewer Installer: — -�n, <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ' ) W <br /> r THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: O 6N <br /> 0 agoG.0 P// cco14c3 74osf5 f v. . CUP- ZI-/o, z z <br /> 70 ICVl'S s/ - �.ee�s 6� MOC42� by /P/%z� ,‘ , w <br /> re c-e sie-e-- Per GtAP- zf- l0 Over I10°0 S/ e, <br /> �l ern u 5 /A - i 1M e�� S/Z e. /I I,T . , Fee Rec: /Zi.� <br /> �`e�a)v'� or rep/aC S y Check#: 3/°/$ <br /> C <br /> Date of staff site visit:C "�/j --, Q�C Initials of site visit staff: bL y , <br /> L._..7._.1S- J <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3/ZeVee 2 r ro <br /> 4Wil <br /> a <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF -, co co n <br /> iniii <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT c o 0 ^' <br /> I ,:: <br /> Transcendent: - Page 1 of 4 n g <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 <br /> C <br /> v <br /> -q <br /> ro <br />