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CA "CI <br /> LAND USE PERMIT APPLICATION— Burnett County, WI c <br /> . 7. - b <br /> . Applicant Complete All Sections Below This Line 5 o <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> CD.d <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 �.�, O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 CD <br /> t <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> G7 VI <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 1 <br /> Filling/Grading $150 Boathouse $500 r- t, <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 — <br /> *NOTE:After the fact permits(permit squired after construction has begun)may cost up to three times the normal fee. S <br /> . P <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. <br /> Property Owner's Name: en L.T /*,✓l/A4)A) z P <br /> Property Owner's Mailing Ad ss: Z '6 rr ,gi,tc A f 6A.Mv (q-);:% 7,(6.4.( C <br /> -- City State Zip - <br /> Property Site Address:2 Y ,gi,CC// /fxolAIP eA1C /a Y41/6141L/ WI SYgyo • <br /> Contact's Telephone Number: .5—i` ef7©" e7/?l z o <br /> o- <br /> Contact's Email: /4at r' 4mti elOP/d 61. e—o 0... d <br /> / w <br /> Legal Description of Property: /or 'V GS/vl i% 7 i 7 n 6„. ,,7` `4T 7 <br /> 0 <br /> . <br /> 5 <br /> Section#: Town#: .17i'.17i' N Range#: / </ W Town of: See TT .. <br /> a*Attach additional page if needed for lengthy description OR attach a copyofthe deed OR attach tax systempropertyPaSe.* <br /> d <br /> Tax ID#(1-5 digit number;found on tax statement): / '/ 6../ ' <br /> Proposed Use of Structure/Addition: f)-o/IA 4: i c I <br /> Anticipated Start Date: S'e,r ?oz o (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ox <br /> Building Contractor: ,TA h:S / jQL/z44/41-Sewer Installer: -3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY p <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: �Q <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ,TVI"construction taking place for any dwellings, dwelling additions,manufactured homes, manufactured z <br /> home additions, and bunkhouses.** <br /> . J — For � ck h. i` �I©r\ <br /> Fee Rec: 1'15 <br /> v, Check#: 47 )lo <br /> c <br /> Date of staff site visi;77---‘6906In 'als of site visit staff: KY --- --- <br /> APPROVED BY LAND SERVICES OFFICIAL 1.11---------- DATE: 7—? 5; <br /> 7.5 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF c m <br /> D G_3 <br /> n m <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° sfl ,N <br /> Transcendent: - Page 1 of 4 ,`` c <br /> Laserfische: Burnett County, WI Land Use Application— Rev 6/2020 < ; <br /> n <br /> c LLa <br />