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LAND USE PERMIT APPLICATION-Burnett County, WI a' `° r <br /> s: � 'fib <br /> Applicant Complete All Sections Below This Line oAo <br /> VN1 <br /> Permit Types and Fees:(Please,check appropriate boxes) d <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 /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 P <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 4� Os <br /> �,reek/Stairs/Patio/Retaining Wali/Sidewel1 ' Bunkhouse $250 i o <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1y)Structures $350 r <br /> Filling/Grading — $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 `gg• <br /> "y <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. , r--, <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 <br /> Z <br /> rl <br /> Property Owner's Name: Ike, rr k,<< 4-- t r er. o <br /> 6' vai <br /> Property Owner's Mailing Address: 9'345- 1 9-.4 ST. '4f1 Etter Lt AL'`J -'3 'o <br /> LEA <br /> City S e Zip a <br /> Property Site Address: Zoo(v( EAioceii 0^,.%t CrairtIctitl0,1z 5li `(0 k' <br /> Contact's Telephone Number: 6206"' 2— a. <br /> 1 b <br /> -X Contact's Email: (Y\I4Ji✓`ji.S-7-PR CZZ / .Cjj/Yn i <br /> Legal Description of Property:Ur ' (Sirkit. c i f1 i Ze (1y,, (� - 3, 1- Z 0 3H o a� <br /> Section#: 2_( Town#: ,3 7 N Range#: 1 b W Town of: 'Tr-G.6e 1c_( o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* q <br /> Tax ID#(1-5 digit number;found on tax statement): 2 3 7(4 3 <br /> a <br /> W <br /> Proposed Use of Structure/Addition: 4{C�, e_1b�.o i .- x <br /> Anticipated Start Date: C—P- Zezz (Home/Cabin;;Commercial Business;Bedroom;Deck;etc.) d <br /> Building Contractor: ' *-ti...f G_:"'':xxc ,. Sewer Installer: H 1\ ) <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY a C N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> ePecn,i- '\--o e ,i1\A 1SA \hc 1E1I z <br /> A l ic; n Q. Gy\ s\�e G l(ou.3�cC1 <br /> t. <br /> .4 Fee Rec:5- e) <br /> y Check#: �� � <br /> r ��} <br /> Date of staff sit : 1' :4 ° (.G ' ials of site visit staff: R\L-- <br /> 4) <br /> r <br /> APPROVED BY LAND SERVICES OFFIC1'''. TE6'`G �. <br /> � I) CD <br /> n <br /> UPON APPROVAL: AP ' LICANT MUST POST COPY OF y <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTzcn <br /> z ? <br /> FA <br /> Transcendent: Page 1 of 4y .. 00 <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2020 e CD Cl C <br /> o °''a 6 1::: 1 <br /> 3 <br /> HL <br /> cliiil <br /> L J <br />