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LAND USE PERMIT APPLICATION— Burnett County, WI a <br /> Applicant Complete Ali Sections Below This Line c c o <br /> n <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure 420Q, in <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,i <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 N <br /> Accessory Structure(Commercial/Industrial) $200 =addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk 3unkhouse $250 <br /> o <br /> Driveways/&Campground Structures $125 ;NI State Statute 59.692)ly)Structures $350 r <br /> c <br /> i ki,cv f v:'.rrg SI.V3 rzatimadti,F-fes' I!Six Month Camping Unit(One Per Year) 1$100 Permit Extension(1 Year Extension-Allowed Once) 1$100 w !, <br /> c <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. <br /> *Correporrinectii.wo,Tooters&S4asrevi:,4eaAfereirta {irthtiav ,ssr,• -eresVerpvnsuiiry s).'}nlireminr,,nns't'eey <br /> *Items not listed above will be treated as accessory structures,stilt as:pergolas,landscaping,etc. I r <br /> Property Owner's Name: `. ) - \. I 1 <br /> Property Owner's Mailing Address: •♦ I 0" �Ci"''\)12 k. <br /> City State Z• <br /> Property Site Address: �1 1 ,3 ( 3 <br /> c N <br /> Contact's Telephone Number: 2/5 ,`")4....N` -2-DE a <br /> Contact's Email: ) i -4o JL0._1Q�0 C 1(11,, cos ' 1CD <br /> Legal Description of Property: o I-0 <br /> Section#: Town#: N Range#: W Town of: <br /> 0 <br /> *Attach additional page if needed for lengthy description OR arta.:h a copy of the deed OR attach tax system property page.* S. <br /> n <br /> Valk -4-Sli 5,ilite-i 71diY tots;%%yd.,on+atx stiatinwatilf. 3 ,~ <br /> Proposed Use of Structure/Addition: it, <br /> Anticipated Start Date: Al/ 'ome,/Ca,n;Commercial Business;Bedroom;Deck;etc.) E <br /> I <br /> Building Contractor:_ I ! 4 �, ik. Sewer Installer: /]j2!/?0-/?0y <br /> ul.� <br /> AREA BELOW THIS LINE FOR LAND SERVICES SFAFF COMMENTS/CONDITIONS ONLY <br /> 'WAS PERMIT %S Sl',SM .C'£ TO MA, X43'K'SS'' '� �Q'�'07`ZS'1.aiSni' j.2 3`34•. OO <br /> z ..0 <br /> xi W <br /> I <br /> co <br /> x Fee Rec:pt C) <br /> hh N Check#: <br /> d <br /> Date of stall site visit: / V (/—" snW:hs o5 sfce visit sta l: 1P( _Q,c_j_q_6"---a <br /> rl <br /> u (� � <br /> APPROVED BY LAND SERVICES OFFICI I ATE:, O L <br /> rti MI <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z 00 `�'{' <br /> N Y"Y <br /> Transcendent: o <br /> �` vo NZ <br /> Page 1 of 4 ; c <br /> 14 <br /> Lyse.hsche: Burnett Caafarty; W1 Land'tIge A tend m—Ret'1,1209 < o <br /> d jl1 <br /> - 3 <br />