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LAND UNE YLKlVIII AYYLICAIION — Burnett County, WI g b <br /> Applicant Complete All Sections Below This Line 0 <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> V <br /> Dwelling/Principal Structure `= . <br /> $300 �` , Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 i <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 co <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C — <br /> ,, i Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r- <br /> Filling/Grading $150 Boathouse <br /> $500o <br /> in Unit(One Per Year) cr. <br /> 1 <br /> Six Month Camping g $100 Permit Extension(1Year Extension Allowed Once) $100 <br /> 0 <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. c--- <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. S. i 1 <br /> Property Owner's Name: / v 1 l �� K e ( ( ° p <br /> Property Owner's Mailing Address: 11 b 0 o f,{L" P-c), 4 nd e& kir /11,vSSS/SS 2' <br /> p �,^ City State Zip <br /> Property Site Address: 2 ©&' 7 gf' ree �1l � ,1 c ck 'i / w <br /> j ? < <br /> Contact's Telephone Number: 6C/- <br /> 3 2 G/'— 9 �/ 0 o a <br /> Contact's Email: M 1 S Ii k le hi r '. 0/'i(,a 1 1 , (0 III <br /> C <br /> t Li <br /> o as <br /> Legal Description of Property: N 3�jQ boy Lo+ /Piw ' 0 l J(?rZ 'Z-Z/G'- I s-� �S <br /> Section#: Town#: N Range#: W Town of: 05-0011-01/600t- = <br /> a <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): S 7 0 S c, <br /> Proposed Use of Structure/Addition: P Lt, '�I el 8- — Ct 6 i n d e4 -_C ire I /006://_1 i <br /> Anticipated Start Date: 6-Z 6` 2 0 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Cj <br /> Building Contractor: /i/A Sewer Installer: -i F u.‘ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY V <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: O <br /> i,_.__ di ...5e.kie r i ir 4 I(Atli:-t;\c>et 5,b,,,o-i-,..Q4 •--f-o cou.i. .A1 z <br /> b Seat . ‘ ) ° ?_____!=0 <br /> O fo( a t\) i t\ ectcifiP Ian <br /> -„ Fee Rec: l <br /> Check#: <br /> 01 _____ d <br /> Date of staff site vi ���'dlitcD-C) Initia of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICI : 4 7 / / oio �i <br /> gi r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ▪ E <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> ro w <br /> � cg's <br /> • Do <br /> Transcendent: - Page 1 of 4 M a c <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 < [ a,, <br /> H / <br />