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• <br /> LAND USE PERMIT APPLICATION —Burnett County, WI g r <br /> Applicant Complete All Sections Below This Line 00 o <br /> Permit Types and Fees:(Please,check appropriate boxes) 0. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 a <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 £O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 N` <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 � <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 5 7 V` <br /> Filling/Grading $150 Boathouse $500 C. b c-c, <br /> o <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. (H? <br /> *Communication Towers&Signs require a diffapplication form;see corresponding application,and fees. :erent <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: RY <br /> Property Owner's Mailing GAdddress: �v I C j U N i P E� DZ n SOME-WET EWE t W I 025 T <br /> I 1 07 N. - M J DI'�� �LM.E 1)Imo- 5\ t`t vw�te Zip p 1 L. <br /> Property Site Address: �j E <br /> p i_ <br /> Contact's Telephone Number: 5 ' 491 1 Yl 4 o N <br /> � • <br /> Contact's Email: RYA N TJ A D I'r G t y I A i 1 L . C 61l I, CD <br /> 0. <br /> LOT 1 CShal N112iP P203 LUT' <br /> Legal Description of Property: W Town of: b(\N((�QV't as ) <br /> Section#: (D Town#: �j31BN Range#: 17 ° <br /> o <br /> o' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* O <br /> a <br /> Tax ID#(1-5 digit number;found on tax statement): 3 4`a.i 2- B <br /> Proposed Use of Structure/Addition: 3 t AG E I� r" <br /> Anticipated Start Date: j U LYo ff <br /> ,z O 20 (Home/Cabin;CaC: "Business;Bedroom;Deck;etc.) x <br /> Building Contractor: S Sewer Installer: N/A. 'e <br /> -3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY , C.)Nj <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to (lS E;U <br /> ANY constriction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhous I-I, A � J ���l /�L6-c-A fa) e Olt" -Pc r <br /> i � <br /> Fee Rec: <br /> Check#: D 7 .2rr- <br /> m <br /> Date of staff site visi • 2 { ,"0r I I. *als of site visit staff: k\L-- <br /> r�,�L,JJ <br /> � 1 <br /> U. <br /> APPROVED BY LAND SERVICES OFFICI• ' • DATE: 6.--;,5---796. 0 S w <br /> UPON APPROVAL: APPS ICANT MUST POST COPY OF C z <br /> < 3 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o o a <br /> Transcendent: - Page 1 of 4 r) 0 <br /> • m• , <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 6/2020 m _ c= <br /> ro <br /> In <br /> Lc—`)) <br />