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LAND USE PERMIT APPLICATION - Burnett County, WI - 7 r <br /> O- <br /> Applicant Complete All Sections Below This Line o'' <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) C) <br /> ro <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 "� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 Q. 0 <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 <br /> ' <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> fDriveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 . r <br /> Filling/Grading $150 Boathouse $500 o <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. 1 <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. t-- <br /> o <br /> Property Owner's Name: C h 0 e l `'l" •�.l eo n Vv a. I 7I (rl oli <br /> I v <br /> Property Owner's Mailing Address: c)"]r),a.5 .S tG1.+e 1 ad 35 LA)e hs-tc it .L 5(I-097E. . <br /> I , 1 , \ City i - . P2. <br /> �'„ <br /> Property Site Address: W h I tt' to I I Ll.J 1 icier n eSS ►'�U Par <br /> o <br /> Contact's Telephone Number: `7 15 -r'S'(c(c, •- 6 a f7 \ a ' , <br /> t , <br /> -r i . Co m o ��Contact's Email: Lan t eta i ) I ICI 1 I�C°jJ h0 �1CllCD <br /> Legal Description of Property: i r1 C 11.t ct e ci N 00 <br /> Section#: ?j c Town#: 1 I-}O N Range#: IL, W Town of: C)a K I a n(� o N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ^.• <br /> m. <br /> Tax ID#(1-5 digit number; found on tax statement): 4 c2 Q 3c Z./ - <br /> 1� i <br /> H <br /> Proposed Use of Structure/Addition: C0.rn t'c1 r0 Lt n d S{"r L-) C+ I�IrkV.1 xAnticipated Start Date: 101(r)ed(Cci-e, Home/Capin;Commercial Business;Bedroom;Deck;etc.) hIN <br /> C7 <br /> Building Contractor: A//A Sewer Installer: — ' , <br /> s <br /> AREA BELOW THIS I,INF. FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o <br /> �� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o N <br /> 0 6'e l) ct t// Gt2/l(44:, JS &wl CUP Z/—/D. z S <br /> e_ oc/'rt-i 6 /a / 26' 71a hi ) 8 <br /> �� 5 5t C'- rt e �s b �`'' y �/ V <br /> /lei e- ,/& , %N 11D cepy/vi tom. bo I t s i i e. /I�w►,jLS pit/'cuP-ZI-I o <br /> ��//� )� I l / _/- 1 L D <br /> a l7ie*i doe- ' IV-e4A►�i ei'/Io&JE.0 ?b /"ereicllk\ LtKTJ'/ /'T Is I'E'/ R1 a Fee Rec: f22S #9 <br /> pr )/'{p/ ecL/ ,vt US7 /4e,1 "wed- S/Ze- //N4/174-$. Check#: enr <br /> Date of staff site vis l ( '--- a I ' ials of site visit staff: 1---- . <br /> Q <br /> APPROVED BY LAND SERVICES OFFICIAL: ./L "'r DATE: 07/a00-V '• r <br /> w <br /> a Pil <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ..0"IR <br /> o <br /> Transcendent: - Page 1 of 4 'Laserfische: - Burnett County, WI Land Use Application -Rev 1/2020 11 <br /> b <br />