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LAND USE PERMIT APPLICATION— Burnett County, WI <br /> . b <br /> Applicant Complete All Sections Below This Line 5' o <br /> Permit Types and Fees:(Please,check appropriate boxes) ° <br /> co <br /> Dwelling/Principal Structure $300 )( Addition/Alteration to Dwelling/Principal Structure $200 B. (� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 rte�J <br /> . . Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 • <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °n &– <br /> Filling/Grading $150 Boathouse $500 C- <br /> Six Month Camping Unit(One Per Year o d <br /> ) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> &-- <br /> cn <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. b <br /> o <br /> g' <br /> Property Owner's Name: b B E.-RT Z,r6 i. z <br /> P <br /> A, <br /> Property Owner's Mailing Address: 5-413 6- 14-ii,5.y�i ,..5-31- /i 1-. y- ,q.;r� <br /> • // <br /> City State Zip -eCt <br /> Property Site Address:59?// P//re A4k,E G) . 443...1:74T f41,cl $9 n <br /> cn <br /> _1 <br /> Contact's Telephone Number: 6/Z - 7 6-- 1`,:5"51© o <br /> Contact's Email: ?-5- 45,e2:1•/e7-.4. 2-4/4 . e- rte. <br /> b <br /> Legal Description of Property: t23 V i / ?3((,o .'. 4vr-3 /f 'f22- <br /> N -v <br /> Section#: (36-- Town#:T39/ (N Range#:47/404) W Town of: fuer ,i/ o 0o <br /> 6. <br /> a`*Attach additional page if needed for lengthydescription OR attach a copyof the deed OR attach tax system propertyPa e.* <br /> d <br /> 7 <br /> E. <br /> Tax ID #(1-5 digit number; found on tax statement): // 90 9 <br /> Proposed Use of Structure/Addition: ovg--e,,,,4. yl/)`eGA- p,J c,y,aF,j `A <br /> Anticipated Start Date: S. e0.-i9-Z o y <br /> p (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) £ x <br /> Building Contractor: e..)Eu✓F <br /> , Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERIVIIT 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 (y t7 <br /> ANY construction taking place for any dwellings,dwelling additions, manufactured homes, manufactured z <br /> home additions, and bunkhouses.** 70 <br /> Fee Rec:_ i. <br /> U Check#: <br /> ...._ Ay,_ <br /> //2 3tir <br /> c <br /> Date of staff site visit:a, Pl,„. Apr % 111" it':ls of site visit staff: zE3-I:cr) <br /> go <br /> c <br /> APPROVED BY LAND SERVICES OFFICI• : :i -P6—�� < <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF aSIGNED PERMIT APPLICATION IN PLAIN SIGHTTranscendent: - Page 1 of 4Laserfische: Burnett County, WI Land Use Application— Rev 6/2020 cA <br /> 0 <br /> a <br /> 3 <br />