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LAND USE PERMIT APPLICATION — Burnett County, WI . <br /> ro <br /> Applicant Complete All Sections Below This Line c' o <br /> - V <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Fi <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 C.7\ <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 1139, <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 c <br /> \/Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $2504 <br /> n Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> r <br /> Filling/Grading $150 Boathouse $500 c <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 K' <br /> a <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. lo <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. .v <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. t— 2- <br /> c .- <br /> 1z <br /> Property Owner's Name: I c - d- lj FU - ., P <br /> 1 -r <br /> 'W <br /> Property Owner's Mailing Address: 1' Lea. r t o(. 134 Doles H A) Z'- " <br /> ��1�10 S City State Zip <br /> Property Site Address: 1 ColP.t� V. v�U <br /> � <br /> Contact's Telephone Number: ee I Z -5 9 —3 (59 7' ' Q , <br /> o�Cc-C.n�'.1A,J vc2 @ j cd.14:- Co,),\ o <br /> Contact's Email: 1 /a <br /> Legal Description of Property: 1-o . 4 - Svcs 1p�„J �pcci 3 x <br /> Section#: a S Town#: 140 N Range#: R 11-f W Town of: U,q(a t' <br /> z <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): 5 5 g.5 <br /> Proposed Use of Structure/Addition: .0e.C14.. (0o4 R 4014 i-0 ('lotat) of•rov- a -6 ('D,( Iti ^„ ,, <br /> (� S x <br /> Anticipated Start Date: QS-Z2-.)010 (Home:Cabin:Commercial Bus Hess;Bedroom:Deck:etc.) = <br /> Building Contractor: I've me O w uer Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONNS LISTED BELOW• d b <br /> z <br /> ° eC -\-- C- de_c pei- %(-,...b(Y\\---W <br /> pvy-k--- ptc,,,le) <br /> Fee Rec: t 112' <br /> Check#: -220 <br /> Date of staff site visi : s 1 Initials of site visit staff: rn <br /> o <br /> 6 <br /> : ›, <br /> APPROVED BY LAND SERVICES OFFICI : i 1.1 _I DATE:, , ) 'cl( g <br /> :___,_4, <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF I, n G� <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT A - N11 <br /> o <br /> Transcendent: - Page 1 of 4 ;',9 i 1 o <br /> Laserfische: - Burnett County, WI Land Use Application-Rev 1/2020 <br /> J <br />