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LAND USE PERMIT APPLICATION—Burnett County, WI b <br /> Applicant Complete All Sections Below This Line o w o <br /> P. <br /> Permit Types and Fees:(Please,check appropriate boxes) .k-1:-_, <br /> 1,3N <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 a <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 -A <br /> 1 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° � <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r. <br /> filling/Grading $150 Boathouse $500o b <br /> i... <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 cn h <br /> g <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. i. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. ` <br /> *Items not fisted above will be treated as accessory structures,such as:pergolas,landscaping,etc. r• I <br /> 0 <br /> Property Owner's Name: 7-7-/(3/^i/1 S /�n 7v N PC w 1 g.c m P > <br /> 0 <br /> o <br /> Property Owner's Mailing Address: P O L3 O X S` 7 S/aOL Al R (Al 1 Ste'/We.)i <br /> City State Zip rn„ ti. <br /> Property Site Address: /0 1 gc.4C' 1</3D2/✓ A O A a 5l'oorvfA. (..,...� i'Yioi X E <br /> r 7 o — <br /> Contact's Telephone Number: (6 /) ) /0 7 .5-- a <br /> q <br /> All <br /> Contact's Email: A /Vl,Nd" /0 C ,-71 S A/ 4'o M <br /> Legal Description of Property: F r /4 T T A C //F_ J N W <br /> Section#: � G Town#: y 0 N Range#: / 9 W Town of: <br /> P.. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* R <br /> 0 <br /> Tax ID#(1-5 digit number;found on tax statement): l g$' 4 q 0 w <br /> Proposed Use of Structure/Addition: /70/''I/. — C /7 0 C'�B a rk <br /> Anticipated Start Date: 6/1,1,2 o a 0 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) x <br /> Building Contractor: A/v 4//: Sewer Installer: N 0 AJ t..1.-1 <br /> n � <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Ptek-----pVes,Y\ 70 <br /> g Fee Rec: I <br /> oa D y Check#: -.20 .3 <br /> I 8 <br /> Date of staff site visit: niti of site visit staff: LA <br /> . , <br /> , . <br /> „, ' __,L-_-_-_)_) <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: q ale i 'ol- m r <br /> w <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 0, a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ,, o o N G <br /> cmc N., o <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2020 i < § i= <br /> a> <br /> y LTJ <br />