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LAND USE PERMIT APPLICATION - Burnett County, WI <br /> Applicant Complete All Sections Below This Line 3 c c <br /> oa <br /> Permit Types and Fees:(Please,check appropriate boxes) �, r <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 %• <br /> AccessoryStructure(Garage,Shed,etc.) T <br /> ( g $150 Addition/Alteration to Accessory Structure $150 � LI <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> ! , ►� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o�j <br /> Driveways/&Campground Structuresy <br /> Y pg $125 WIState Statute 59.692(lv)Structures $350 <br /> r <br /> LFillin /Grading $150 Boathouse $500 2 L. <br /> Six Month Camping Unit(One Per Year) $100 _ Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. iv <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. , g" 3 <br /> '^ O z <br /> Property Owner's Name: barj J3�4,�V c > > ^ , //Wit P <br /> o <br /> Property Owner's Mailing Address: J-30?1/6 i<e rt' f-. n,il SI:' /(tr►CLS ,17 U <br /> (� City State Zi c <br /> Property Site Address: 5 j(�70 4 <br /> Contact's Telephone Number: 7 "' q 0 6�� o a <br /> `7 <br /> Contact's Email: ra—b V^o2 G Oa` G 1 Cc) 0 <br /> J� ro <br /> Legal Description of Property: /lye n Q 1 Ote 2_4.- -1- c b <br /> 5 5' <br /> Section#: c Town#:101 ' N Range#T-3?) W Town of: l ee,lOrl 0C <br /> 0 <br /> *Attach additional page if needed for lengthy description OR at c'/4,Ct)a�copy of the deed OR attach tax system property page.* <br /> Lj /7 <br /> Tax ID#(1-5 digit number; found on tax statement):3; 3 <br /> p C.0 3SC)r. s•)rt-cue 15 lct _ p e os o <br /> Proposed Use of Structure/A4dition: o x <br /> Anticipated Start Date: 3 tti 1 i _�Q ..-0 Home/Cabin;Commercial Business;Bedroom Deck, etc.) ° C7 <br /> Building Contractor: U VVV Sewer Installer: H <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ..1 <br /> Ca Ma14e_ Sure S\rc.zc't use 'i S L/0 'ero►�1- z k.)3 <br /> pz <br /> Ce�r/mne c3-P .e rood e �-bae.K.S <br /> o- 'Mai n'F-o.% n a' 1'ea.S-r f t® ' Id <br /> ficf <br /> re ire MI -car /i Ufrtlavt �, `` 7Li'csr>I <br /> Fee Rec: // <br /> 56 <br /> Q s Check#:('c <br /> 1<1 ao� KDate of staff site visit: Initials of site visit staff: <br /> z <br /> APPROVED BY LAND SERVICES OFFICI <br /> 6 <br /> AIL...cs `-�'" DATE: �Q, c, <br /> x C <br /> UPON APPROVAL: APPLICANT MUST POST OPY OF U i ` T <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT i 5 c <br /> Transcendent: - F v C <br /> Page 1 of 4 -0 , ; <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 < n C <br /> C m G <br /> r <br />