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LAND USE PERMIT APPLICATION - Burnett County, WI fb <br /> Applicant Complete All Sections Below This Line o <br /> 0. <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> ' Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 " •F's <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Che�etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 R--/ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 �1 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r- 11,V <br /> Filling/Grading $150 Boathouse o <br /> g� $500 , <br /> `K Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 I cn <br /> m <br /> 5. <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun) may cost up to three times the normal fee. E <br /> sr- <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. co <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r <br /> O Z <br /> Property Owner's Name: 7)0, ,1 r et ci 4` Q),_,t,, c'� -44 t&a,Lr o ` <br /> ET <br /> Property Owner's Mailing Address: c21i4 J ,c4-0.e_ d �ci (LE ._S(i j c <br /> 7�! City State Zip c <br /> Property Site Address: 13. 3 (-)6 re4 1E' Spa.)A /�C�l <br /> o <br /> Contact's Telephone Number: 7/5= c f, ,c _,2 6I,,,, l cc j 'L%� � , • a <br /> Contact's Email: A1hi (cue,&AO-17M.r 1� C-o" <br /> Legal Description of Property:, 0- 1 r ✓ s Ip 3„).-6 �l b((t.fP.( rA ?p if 04.0 t -) c ac <br /> 2. <br /> Section#: (-)%3 Town#: HO N Range#: /LI- W Town of: ____Sr_0•i f- <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): 1(PJS 7 7 <br /> a <br /> Proposed Use of Structure/Addition: -}Z�{�.,�.� w <br /> Anticipated Start Date:(,AJ __coo I c{„JL (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ° C7 <br /> q '-'iL ��J e,-,,,,,A,.v <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> • c c e�t n 5. b ac.K 5 -Pro m sic�.�. (a+ t,�&.e <br /> ck v\A fiAo Lk.n a 0- - I a-pee'1-= <br /> • f'e-c J j+ s'-p r R-L .wtisk r h l' ...4--'t o <br /> H Fee Rec:t`i61)oa <br /> U Check#: ' ' V7 <br /> Date of staff site visit: { dv13-4) ..." Initia of site visit staff: tk V-- e <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:OCV0,9¢g..0 i <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF " > . <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 4tirj <br /> :<• 0o _ <br /> Transcendent: - Page 1 of 4 w.� <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 • N r <br /> 1 kms. <br /> 4 <br />