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LAND USE PERMIT APPLICATION - Burnett County, WI I r <br /> a b <br /> pp cant CWItrerkions Below This Line 5' c o <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) d ( , <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 " <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 W <br /> '7( Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 1 R <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 G7 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r �• <br /> Filling/Grading $150 Boathouse $500 0 <br /> Six Month Ca '•'•: 0•- •-r Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 �' _ <br /> R. <br /> *NOTE:After-the-fact permits(permit aqui red after .- uction has begun)may cost up to three times the normal fee. , 1, <br /> *Communication Towers&Signs require a different applicat'-,n form;see corresponding application,and fees. o <br /> \*Items not listed above WI .- • • - ctures,such as:pergolas,landscaping,etc. r- pi, <br /> z <br /> Property Owner's Name:Cori-4- -g('( RO6L,10 y 9 <br /> Property Owner's Mailing Address: V tD'j Ft 5+'-'- . Cf. ti Rose01d1A%4-- AA a-0CPn rr <br /> City State Zip <br /> Property Site Address1:4 �.D ..35-pis E <br /> Contact's Telephone Number: a S <br /> Contact's Email: ISS vsL oZ q tQ Nti,,,,, 1 . C <br /> Legal Description of Property: C .A6 c/( c 6 t---e (, crc <br /> Section#: Z I• Town#: 31 N Range#: I 1 W Town of: cm <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* �. <br /> Fi <br /> Tax ID#(1-5 digit number;found on tax statement): 361143 <br /> I t CA Io y <br /> Proposed Use of Structure/Addition: SrLe ° <br /> Anticipated Start Date: Corv��k -e, +� (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) , C7 <br /> Building Contractor: ` re,` .C-A, h Sewer Installer: /U/� i y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY �1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ► `" - <br /> Ti S <br /> Fee Rec: .225a-P- <br /> ._ <br /> Ill <br /> Check#: L(DLO <br /> DT <br /> 67 Date of staff site visit: 0,0Init' of site visit staff: r _ <br /> APPROVED BY LAND SERVICES OFFICI DATE: ^ v• va <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF co • f?), <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o . <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 M <br /> tl. J <br /> i <br />