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- LAND USE PERMIT APPLICATION - Burnett County, WI a r <br /> Applicant Complete All Sections Below This Line g o <br /> C. <br /> Permit Types and Fees:(Please,check appropriate boxes) d W <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ", . c, <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> CI i <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 a <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deckrtatozf/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> A Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 C- 1. <br /> o <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 w <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. a <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. 2 c <br /> o Nh <br /> . <br /> Property Owner's Name: iliA l' Ck.i' ' aS0 -n ° <br /> Property Owner's Mailing Address: I 59 et n5-0, pte t re'n-lor�,, �- 901-1 <br /> [� City State Zipn <br /> Property Site Address:C:5Ci clOii✓r a� tJ ;i/`( �Ctir\h,',. GtIS ,9-/ 3 0 c <br /> Contact's Telephone Number: -7 1 5 ti 3i 1`.1 (-7 o. <br /> Contact's Email: Ak^t- .O1s0,0 kokaisce.i\ , (omkr <br /> Legal Description of Property: �C�' �Z <br /> � St'(�+S v t 'r''.) Z LA.) Pc, le- t—rJ+ 5 <br /> Section#: _" Town#: HI k.) N Range#: [(oW Town of: S ; <S d <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 4 <br /> Tax ID#(1-5 digit number; found on tax statement)q:2_&3-1 cn <br /> Proposed Use of Structure/Addition: 3—u(r-W c t 0 (c,kC vic�00�/ 0 <br /> Anticipated Start Date: /` I i` ��C C7 (Home/Cabin;Commerci 'l Business;Bedroom;Deck;etc.) ti) <br /> d <br /> Building Contractor: (�_ I Sewer Installer: H i\.i <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY f <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> z <br /> m <br /> • .r Ve— e_ e- ‘a 4 w til -sS '--1- a4)- <br /> c ko tI t' e_ . pjo Oil„t LAS l 1s or C.,141X`l” ; 1'1 ,S G. 1L (as <br /> to <br /> e y -1- r=Q,r ..c.ce- C t cia o <br /> x Fee Rea <br /> Q �© Check#: 3b <br /> ti r o <br /> Date of staff site visit: Initi sof site visit staff: a. _ .- <br /> z <br /> KC)-- <br /> APPROVED BY LAND SERVICES OFFICI : l it/�� i a " <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ' 4 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT t- <br /> Transcendent: Page 1 of 4 c <br /> N <br /> czt <br /> Laserfische: Burnett County, WI Land Use Application-Rev 1/2020 _ gRi <br />