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' LAND USE PERMIT APPLICATION - Burnett County, WI a _ <br /> N <br /> Applicant Complete All Sections Below This Line g o <br /> CD I <br /> n. <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> CD <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 2 <br /> o <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 m <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150t, <br /> G <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o O• <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 C- <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 <br /> ISI <br /> *NOTE:After-the-fact permits(permit aqui red 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 /> CD <br /> *Items not listed above will be treated as accessory structures,tr �( such as:pergolas,landscaping,etc. /� 3 ASenn (__ <br /> Property Owner's Name: IVO fn1 k �Je Tef'e>i . tit.) '_ L., P6 <br /> Property Owner's Mailing Address:Agati 246,6• "-‘-i int. 6/a/1 1414 (,A✓-� 3-6/1P/0 2' <br /> City u State Zip <br /> Property Site Address: -/O f Z.zkeL Alt) .r./ LO/' <br /> Contact's Telephone Number: ---7 /5 — LIF? '.... 6', .E.3 7:r.,‘Contact's Email: 1'.\I,5A C�C.(t ["4 J 4o '/ g m ' �tYrk K G <br /> Legal Description of Property: 01— 03 y 2---3'2-/8 o--/ oV-ono- o 13 orro <br /> Section#: 02_0 Town#: 3 t7 N Range#: /6 W Town of: 'Tree '- ,e, cro <br /> 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): A 3(o q7 c, <br /> Proposed Use of Structure/Addition: 6e4' je / 5}\ed <br /> Anticipated Start Date: j-Llyl 1 S ,.� .. a. (Home/Cabin;Commercial Business;Bedroom; <br /> Deck;etc.) p <br /> Building Contractor: AM Sewer Installer: i/.4 H ]O\ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO LL CONDITIONS LISTED BELOW: <br /> rile- :1 <br /> -i Fee Rec: /J�� <br /> y Check#: g3 <br /> d <br /> Date of staff site visit: 7/ 79(-Z (-Initials of site visit staff: �� a <br /> APPROVED BY LAND SERVICES OFFICIAL DATE: 5196P,090,090 6 �� <br /> r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF -. a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT a m a RI <br /> F yn w <br /> Transcendent: - Page 1 of 4 M w'� r� Q <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2020 P go RI <br /> cn <br /> a L= <br />