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LAND USE PERMIT APPLICATION—Burnett County, WI g. 4 <br /> Applicant Complete All Sections Below This Line 0 Q <br /> _0. <br /> Permit Types and Fees:(Please,check appropriate boxes) It <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 `' <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 1 RI <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 rt:Filling/Grading $150 Boathouse $500 ° • <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> F. <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. & v <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. W I. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. k-, i k <br /> • <br /> Property Owner's Name: u ^ d1 Av., -' S U,e o I <br /> /- �,/ n ,� gam_ , <br /> Property Owner's Mailing Address: 7(r / /S Y +. %'e 4'4 �d'�tGfd;!er, �'6 3Q)$ <br /> City State Zip =' <br /> Property Site Address: Al� E <br /> o <br /> Contact's Telephone Number: c-(' C.s.5d-- Y.11`/ <br /> Contact's Email: k Jail. F,4,,.1 2/;01 1 e ,,.....tat I. C CJ <br /> rf <br /> Legal Description of Property: -izx a >Lc LA o <br /> Section#: 3 4 Town#: IN N Range#: /7 W Town of: U rpt c a„ uo <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* O <br /> Tax ID#(1-5 digit number;found on tax statement): cL 6 4/93 (1 —i <br /> Proposed Use of Structure/Addition: 5-a ra /W,2 5ke� r- s tc,' .-Anticipated Start Date: b-/- (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) OBuilding Contractor: 0 w.1 e ` Sewer Installer: . <br /> r. ,s...) <br /> AREA BELOW TRIS LINE FOR LAND SERVICES STAFF COM V ENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ' <br /> z 1,1 <br /> z---=^it. <br /> g Fee Rec: i`)V— <br /> i Check#: .210 ) <br /> /� <br /> m <br /> Date of staff site visit: 0 / 0 ° I ,Is of site visit staff: , <br /> ) -----i ___k <br /> APPROVED BY LAND RVICES OFFICIAL: DATE: i <br /> S GA J <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ; m m <br /> Transcendent: - Page 1 of 4 70 0 <br /> g w n <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2020 `� 1D ` <br /> 7Q <br /> gill <br /> Lc.-- <br />