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LAND USE PERMIT APPLICATION—Burnett County, WI ro <br /> Applicant Complete All Sections Below This Line 0 c o <br /> P. <br /> Permit Types and Fees:(Please,check appropriate boxes) w� <br /> /Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 Fi' <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 /> AccessoryStructure Commercial Industrial <br /> (Commercial/Industrial)) $200 Addition/Alteration to Bunkhouse $150 :c.) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c IIIIII <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. <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.. n <br /> // / W ��,1 <br /> Property Owner's Name:C�juries � C'''Lt,1,l'� e-�� ern_ _ .. <br /> joc-....j r0 <br /> Property Owner's Mailing Address: /0 300 .4/ero R d . Gran-�5bu✓q U2 5�8y0 ��i. <br /> Alert) <br /> / i� _ City J State Zip = En„ <br /> Property Site Address:10300 /Vert) /1 l own o f 0 on I e/S C <br /> Contact's Telephone Number: 6 5i / D c' q/3 5p <br /> Contact's Email:CID bk/e l -r', € xaiuo , 1 o 0,1 6n 5tr eq ka.D.cain " t <br /> Legal Description of Property:07.00 6 - -38-I 2-3/-1 0Y--000 -- 01 a U 0 0 N <br /> o b <br /> r� <br /> Section#: 3 / Town#: 3 S N Range#: /7 W Town of: Dan i el s d <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): of 7 g5 <br /> Proposed Use of Structure/Addition: 4/0 m e _ <br /> Anticipated Start Date: 5- 1.5,00 do (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Reconnec I._ C7 <br /> S <br /> ' ,/ • L <br /> /�- / <br /> Building Contractor:l a l^,j d S /'"e n K— L Sewer Installer: ,y/g / j by CP K 5 `n k) <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT I SUBJECT TO ALL CONDITI NS LISTED BELOW: =t <br /> --'r to zoikicisq6/4-5-33(Doeu4_,„ <br /> -- Qec rvk"►'r -c 3 be-ol✓'d°"A 46 u z-- <br /> .- Fee Rec:13cO <br /> x <br /> Check#: �J� � <br /> ;276i; <br /> Date of staff site visit: ' nfitials of site visit staff: I a <br /> z <br /> APPROVED BY LAND SERVICES OF1 DATE: ' . © • CD <br /> UPON APPROVAL: APPLICANT MUST POST CO ' Y OF a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT -, 1 3 Gifil <br /> Transcendent: - Page 1 of 4 oE <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2020 2ll <br /> du <br /> F. <br /> L J <br /> - <br /> b <br />