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• t • LAND USE PERMIT APPLICATION— Burnett County, WI <br /> Applicant Complete All Sections Below This Line c c o <br /> Permit Types and Fees:(Please,check appropriate boxes) ¢ t1,1 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> W <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 t O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150R <br /> XDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 <br /> o <br /> ' 67: <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(lYear 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. z <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. ;a-- T <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: i t'5e- N V, 0.L-U Ni o r <br /> Property Owner's Mailing Address: \'Y1'4'1,1cM'-�'4'1,1 46. r )5 bC ��J(ilk/,�lQi N) SS 3a--'8 <br /> \\ City J State Zip <br /> Property Site Address: ' (' C�j i[ r u, ?C\ \ k.)/ �A co, \A..) ° m <br /> I <br /> Contact's Telephone Number: ( G 5 l ) 5 3_ `% S.), o <br /> C. <br /> Contact's Email: C%�(rje r1 b�\1111 e) o r'Y\c; \ <br /> , , CC)e-Yl CD <br /> d <br /> F <br /> Legal Description of Property: <br /> Section#:2.)--') Town#: 14 ° °° <br /> 0 N Range#: 1 (3 W Town of: 0 n,0 y'1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p <br /> Tax ID#(1-5 digit number; found on tax statement): —1531- 3 <br /> Proposed Use of Structure/Addition: C .ft-. Lv G v c" <br /> --3 —1 <br /> Anticipated Start Date: tlt-�,' , "'' 2 Ct.z C) (Home abin;Commercial Business;Bedroom;Deck;etc.) ox <br /> E. <br /> Building Contractor: Sewer Installer: <br /> -3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Ch11 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ,J <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings, dwelling additions, manufactured homes, manufactured Z <br /> home additions,and bunkhouses.** x <br /> 6 Cir; C0 0Ari a -e`er c I/os€r 10 --Pocvezi-e. <br /> Aotn -7 45---Peet: 4- <br /> �j� k��1 !Z2 <br /> a f0W0l0 �(.L� 1 e-a p = Fee Rec: <br /> P <br /> U Check#: /6".2. <br /> e <br /> Date of staff site visit:**7----7--- / *if .1 of site visit staff: K Z,-- <br /> . <br /> os ' <br /> s nI � <br /> APPROVED BY LAND SERVICES OFFICI• I DATE: ,S_____-7"— ---(969?") < m <br /> n71 = MI <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 0.0 <br /> git <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° . w <br /> -C 0 O o <br /> Transcendent: Page 1 of 4 7 ,env <br /> Burnett County, WI Land Use Application—Rev 6/2020 g o <br /> Lasediische: - 4 <br /> 0 <br /> 3 <br />