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r _ <br /> LAND USE PERMIT APPLICATION - Burnett Count?, W1 <br /> Permit Types and feesfAlease,check appropriate boxes/ _ 4 <br /> Dwe lingjlr.ncipal Structure $300 Aadt;oi,!A�teat, <br /> -- r if Structure s'X <br /> Con meraaiJlndustral Structure 5300 Addktronr'Attefatec, ,.LuArla+Structure S20C ul <br /> AccessoryStructure IGara e,She+ e 51.50 Adidrtlon/Alteration t tructvre S15C i <br /> Accessory Structure ICommer,_;� I _,i. $200 Addrtwn/Alteratc,v t_ �_-o,. 51513 <br /> Deck/Sta;rs Pati Retaining Wal tdewalk 5unkhouse $25C T <br /> CJrireways( Campground Structures 5;2 Wi State Statute 59.6921Ivi Structures 5150 - <br /> fdlin IGradrn S1S0 Boathouse 5aOc <br /> SoFar Panels Stand alone or root mounted' $:50 Permit Extension I Year Extension-Allowed On-cei SIX <br /> NOTE:Atter-tare-fact permits!permit acqu,red after construction has hegunj may cost up to three tines the normal tee. <br /> 'Communication rowers.Camping permits&signs require a different apphcatlon form,see corresponding apahcar on,and fees. <br /> 'Items not listed above will be treated as accessary structures,such as..aergoles,tandscaprng,etc. _ <br /> Properv, 0%%ncr'a!!ante. jGu/G'/1 <br /> Pruperl% 0%%ner'.Rlaihn Addle— �^< <br /> n I_sp -C <br /> Properv, Site Address: 'V _ e _ __1Q(�Qsrt2,r. __OS IsW0 ' <br /> C'ixtt;►c[ . T.Irphunc lumber: ✓l, /( 6 �i�/ KP� <br /> t'txtlaa:t'st--mail a��(��. ��Y1 l�( `((/_1!1- <br /> "If stall has a yucshun;ut this appli'aliun. %ou;Sill he conla�t�d r is vanid. Xlakr sure your vnl.ail iddres�v- <br /> leuthle and Nour crruil prm sder will:accept cn-wils!ream the following address; a I3urncltCou;nly%k I goo �( <br /> W <br /> Dra b <br /> Legal rriptiun of 1 rtgwrn LOT 1 � 4_) t <br /> 1c.tyrn a: Tulin -. N Rangea: N' Tuun of: _ <br /> 'A rfeftll aht'hil enat flu*:, d Pw.da .o 1"ngttt a1e-�'11pli-m oRafratll a tgii eft rile deedOR arras h rat tfite'mpit)pt- ?i <br /> Tax Ill=t 1-5 dagil number:found on tax eta •rnent : 94kL_avec, <br /> �,�.y N - <br /> Pro used I;sr ul Structure.A ditto _ <br /> P . �3 � S1 � � -_�i.Ctc'llC� <br /> ` A s o0 <br /> :1ntlapat�d Jt�tr1 1}alC. rr�i,'��haa.t •rk�m-r ;.a:bt�,ir r.t lk'�drkr m fA t d t;. ,t� <br /> Iluildmg C'untractur �/z� S r*, C, ►fit Sewer In_-steller: j O 'C7�t <br /> V" <br /> THIS PER NII I IS St 1IJECf TO ALL CON DI PIONS LISTED BEL(M <br /> r IN��S 11 y � Y► ' (N"` Fee Rk!' <br /> rf i'rne. C'lar 2U F�c <br /> 1' <br /> r i <br /> Ov+1 -t C <br /> Date Uf staff site visit: l y I5 In%lials u1+it s tsit stets: <br /> r <br /> AP11RI►11:1)11N 1.%N1) .t.RN 1l I., t)11-1t 1 kIC'���✓ct a+�I1.: ! ZF Z02Z'S � 0_ c� lJ u ll <br /> rn CO <br /> CD C Z <br /> UPON APPROVAL: APPLICANT MLW POST COPS' OF �.CD <br /> CD <br /> CD <br /> SIGNED PERINMIT APPLIC LAIN SIGHT [� <br /> Q <br /> Burnell County. W1 Land Use Application— Rey 1 U2024 C <br />