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LAND USE PERMIT APPLICATION - Burnett County, WI <br /> � r <br /> Applicant Complete All Sections Below This Line o y " <br /> d <br /> Permit Types and Fees:(Please,check appropriate boxes) � <br /> x Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 U� <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 �� <br /> CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse o <br /> $250 � <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r. <br /> Filling/Grading $150 Boathouse $500 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <br /> *NOTE:After-the-fact permits(permit aqui red 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. CD <br /> o CD <br /> Property Owner's Name: 1 I 5����� <br /> t�� hwr �3 i�ribev- Lu z <br /> Property Owner's Mailing Address: 3 13a-o } A �f`XA 1 Lt �(eT f�otZ, z <br /> Z 5 _ City State Zp <br /> Property Site Address: 6? f, i YZL j+ 1 5 lA Aj � C !12�1;1 bQt�.hU(u/ Ic�� �`y <br /> o N� IA <br /> Contact's Telephone Number: 1�-sflVge 1�C�t nh Z 15-5 alj_Z�3 a <br /> Contact's Email: (`q 61 0?e fie f''S p l j I, M az A <br /> Legal Description of Property: G L, 7 N <br /> Section#: Town#'q0 * N Range#:��W Town of: Se-0 <br /> d <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* R <br /> Tax ID#(1-5 digit number;found on tax statement): O IS-7 <br /> Proposed Use of Structure/Addition: f`" n AVZ42E- <br /> l 1 (Hom Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Anticipated Start Date: M�� 10 C7 <br /> Building Contractor: 1?P—Te(6 0yV LOvLST Sewer Installer: I�t Q(7'���}kjS AV-b i q cN 14 y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 01 <br /> S�f/oPS VNO/ �a4f a( '�4 / J 3 �G OEM SySJ`C�"t/ <br /> z Fee Rec: <br /> Check#: 933a' <br /> Date of staff site visit: Initials of site visit staff: <br /> 1 o <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3/- 70 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o ^, <br /> N <br /> O <br /> +` GC <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 <br /> a <br /> ro <br />