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r <br /> LAND USE PERMIT APPLICATION -Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5' rel c <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 2., <br /> v <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $1501 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< F <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r IIII <br /> ll <br /> o ' <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 c <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. �, <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- 5. <br /> Property Owner's Name: In ArR.K 111 I AI,/ 6-77-e :oh n 5 O n *, <br /> I 6f6618 <br /> Property Owner's Mailing Address: C 61! 10 L p q r-c a r-N per S fame, W I <br /> �J City State Zip o' rte„ r <br /> Property Site Address: 'SA-" E. CP <br /> O• <br /> Contact's Telephone Number: 9.7 i 5 - q 3 q- 07 3 3 Qa , <br /> Contact's Email: Min.)(rl.) a+ Iq k c e out 1 00 k <br /> . col, CD <br /> Legal Description of Property: Pro?e r4-y Li 5+1 n J 41-'11- fic 14.0) o oo <br /> o <br /> Section#: 10 Town#: 3 q N Range#: I`l W Town of: IC p <br /> S k (CO <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> r, <br /> Tax ID#(1-5 digit number;found on tax statement): 157 87 r„ <br /> s4 orc4 etc0 <br /> Proposed Use of Structure/Addition: S edx <br /> Anticipated Start Date: Gs' 10^ 20 2 O (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ..,,��\\ d <br /> Building Contractor:KoWg Pre bu 't Sewer Installer: HA) y <v <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY �` <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> pJ <br /> ,, art AINk\ 6.t- Veasi I0c$ row\-V- 'e <br /> CI.Z. tom Ville `cscrt c4 I. <br /> Fee Rec/5 .. <br /> Check#:70101), <br /> ri <br /> Date of staff site visit: (3°AMP <br /> Initia of site visit staff: t-�___.__ <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 'Y '(;°) <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT t'. " '' <br /> s„' c <br /> Transcendent: - °.=c r...)Pagelof4 c <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 ` gifil <br /> L J <br /> b <br />