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• <br /> LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> Applicant Complete All Sections Below This Line c o <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 'J <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> XAccessory Structure(Garage hen, tc.) $t�50 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 :; <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 4� h:- IIlk <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 r <br /> ,,r <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 0 , <br /> kn <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. <br /> Property Owner's Name: �Q"V)e 5 T C.ksc7Y'1 z <br /> /� 'l o , <br /> Property Owner's Mailing Address: Z'/ 3 ( Ie Rd. Grr'trt-bol"q WI 9124 0 8 II <br /> 8 <br /> City) State Zip b <br /> Property Site Address: 2.1 S'3 (l it R R . /1 <br /> r' ii . (i) <br /> Contact's Telephone Number: 57- Z or- h. 1/9 ) o gl <br /> Contact's Email: j i enJ 4 C. k s or) 073() 5 mai 1. CO nn ? <br /> Legal Description of Property: 2'i 8q 3 co I L e RD <br /> N b <br /> Section#: 33 Town#: 39 N Range#: IT W Town of: Wilts* M4r51,/4 Vi et ci` <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> ' <br /> Tax ID#(1-5 digit number;found on tax statement): 2 8 0 8 3 . <br /> Proposed Use of Structure/ ddition: Shof'Y{ e Shed c.)Anticipated Start Date: "1.5.-Z. `? o <br /> ' (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o <br /> g d <br /> Building Contractor: N/A Sewer Installer: A/�,q <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: C <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to p% <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured (),1home additions,and bunkhouses.** %u <br /> g Fee Rec: t5DcD <br /> Check#: <br /> r <br /> Date of staff site visit d k �f 96 <br /> Ini . sof site visit staff: )2----" CV <br /> Zz <br /> tiv <br /> APPROVED BY LAND SERVICES OFFICI. i ` DATE 2-(' ?o <br /> < �0.� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF r a NI <br /> -e0 c <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT r <br /> co ,..., <br /> Transcendent: - Page 1 of 4 K coo b <br /> Laserfische: Burnett County,WI Land Use Application—Rev 6/2020 Q <br /> C m <br /> RI <br /> LTJ <br />