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LAND USE PER1�►IIT APPLICATION -Burnett County, WI a `° r <br /> b <br /> Applicant Complete All Sections Below This Line a. z c <br /> n. <br /> Pe t Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200iT j <br /> i Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ` `' 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> ...t. g <br /> i Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> G7 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> Driveways/&Campground Structures $125 WI State Statute 59.692)ly)Structures S350 t. <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension Allowed Once) $100 P <br /> i <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> Property Owner's Name: _,ick n,-e-` ii M ic..1�e_I -.JU.r) k-C✓ Q".. <br /> Property Owner's Mailing Address 2-2$y(6 LA-)eS+ ..,_iJer rej 6i,zntSb�;.4_ u1 I S`46`b E I 1 I I <br /> t Q`0 7` City tate Zip g en i� <br /> \..J <br /> ii <br /> Property Site Address: — l .1 ex R Li C.-,r...h f5-)6' 2 PCl (J I S L(7'-3_)_____ I 4 <br /> Contact's Telephone Number: (at 2_— 203 - OS 1 \ J o <br /> 612.-W <br /> � . <br /> Contact's Email:C _.,W wt+--IrL� k til c LIS• K....t Z• min ' US d t. <br /> Legal Description of Property: S 0.-4-}SCI NI <br /> o w� <br /> Section#: 25 Town#: 3 g N Range#: 2-O. W Town of: Cj C421,N -5-6\.a..f Cv. od <br /> *Attach additional page if needed for lengthy description OR attach a ov of the deed OR attach tax system property page.*3"D" 3.�Tax ID#(1-5 digit number;found on tax statement): c„ <br /> o -1 <br /> Proposed Use of Structure/Addition- 1 We_ I ; n 4-y <br /> i <br /> Anticipated Start Date: 5 ' 3b\,2D !Hobo:Cabin.Commercial Business;Bedroom;Deck:etc.) = G <br /> Building Contractor: M 7 (e..-1 3—cA.3r1 —e-_ Sewer Installer: R(1)SS TL\tiY1d e--( c <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY �j <br /> THIS PERMIT IS SUBJECITO ALL CONDITIONS LISTED BELOW: <br /> Nzellyn5 c��ST e ck* vea,91-- S$ --crones <br /> 74 4. <br /> irvvdt,t,c) nig k 10 -ce e1 --crcm 6StKx41 yCtA <br /> 6 410 u�c kr ONCVs teOf ill fv_-dt <br /> , <br /> z 430 <br /> -� Fee Rec: <br /> N Check* (r)l, <br /> f✓ m <br /> Date of staff site visit: Initials f site visit staff: Iii <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: r <br /> UPON APPROVAL: APPLICANT MUST POST 0 ' Y OF r o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTo <br /> Transcendent: - Page 1 of 4 w, 1 o c4 <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 (1!l <br /> v <br /> L <br /> i <br /> b <br />