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LAND USE PERMIT APPLICATION— Burnett County. WI <br /> Applicant Complete All Sections Below This Line " e <br /> _ a <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure 5300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure S300 Ado in or/Al te ration toCommercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ' 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $15o ;.� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 W9 State Statute 59.692(ly)Structures $350 — <br /> Fillin Gradin $150 F Boathouse SS00 <br /> Six Month Camping Unit(One Per Year) $10OF Permit Extension(1 Year Extension-Aliowed Once] <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. - <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. — r, <br /> Property Owner's Name: MA"A& 1 M0"N-1 A►ft) 5-fi�641J "aN � <br /> Property Owner's Mailing Address: S4;t Alkw Ay Ukik <br /> _ -- — <br /> City State Zip s �S <br /> Property Site Address: _ �V S-.j o Ll-ANON UK — bA rJ j 14," _ %ej► <br /> G <br /> Contact's Telephone Number. Architect contact: <br /> John Greene <br /> Contact's Email: MoylwC4 M-.-p t. 34 e, AWN Architects <br /> ...__-..- �t ,t.t�^* -- 651 4284185 <br /> Legal Description of Property: ....-.-Tej,tA,/ntjt Aetj y i <br /> Section 23 Town#. 40 N Range#: 16 __.W Town of. Oakland , <br /> *,ttraeh additional page if'n eede.d far 1 engtiir description OR artach a copy of the steed OR attach lay system propertt;page. <br /> n <br /> Tax I#(1-5 digit number; found on tax statement):_14926 <br /> Proposed Use of Structure,'Addition: Home/Cabin <br /> Anticipated Mart Date: 9/3119 (home(akin.Commercial Business, Bedrown, Deck,elr r — <br /> Building Contractor: David L. Anderson (4484) Sewer Installer: NA <br /> AREA BELOW THIS L[NE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY l• <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Qa�►o�c)glf S new' -710 1011bJJM �e A4MdMd/ }�ef''`"i7L- J' ' , r <br /> /vCtA��T1,71/ -(;�9 017Iw 4-1 7� �� o��by <br /> �c°�'w►i elC�7/yet�7��� S e.e. c.//crGG�G� 2�a t�i m� <br /> ,69V� ,s ��u� use - 5 � � �,�q�y p ��sS� <br /> -+ Fee Rec: ZoD. <br /> �7 /� e /�rf check : SS'8`9 <br /> Date of staff site visit: ( Z Initials of site visit staff: /� 7 d n j�p ,L � <br /> Q n 6CD <br /> 7� <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> w <br /> UPON APPROVAL: APPLICANT MUST POST CO Y OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT m N (� <br /> Transcendent: 0 c �7 <br /> Page 1 of 4 <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 < a to <br /> a � <br /> a <br /> X <br />