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LAND USE PERMIT APPLICATION —Burnett County, WI c <br /> cr <br /> b <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> � T d <br /> Dwelling/Principal Structure _$300 X Addition/Alteration to Dwelling/Principal Structure $200 v <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 C i <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 C) <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o <br /> Filling/Grading $150 Boathouse $500 0 >, • <br /> viik <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 lf�!" <br /> Cr to <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. ai <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,/ g,etc. <br /> Property Owner's Nan �f 1`-E. 4 M � /.--"7 <br /> — #'`��ki N 0 €t _ <br /> J E, . <br /> z ' <br /> Property Owner's Mailing Address: <br /> 27-77 S- DA r0TA AVE, I'&W( C- 1 �U \0 V <br /> 33I RR CA NE.: T)n- SPOONCYL UutCity + D1State Zip (j) n <br /> Property Site Address: F2. :44_ <br /> `�j o � <br /> C � Zontact's Telephone Number: ' sj( p <br /> ® <br /> Contact's Email h1 iZ -N(� U��o N 14 a �'(� 1�7�a C �Y� o Ni <br /> Legal Description of Property: <br /> N m <br /> Section#: i3 Town#: 41) N Range#: ' W Town of: 0 <br /> vo <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): f 01 0 `% j <br /> Proposed Use of Structur Addition: -3 H <br /> Anticipated Start Date: — 1 -' Q2.O (Home,Cabin:Commercial Business:Bedroom:Deck;etc.) o x <br /> Building Contractor JE \F -y KOV-A �� e'er Installer: <br /> -1 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ,*CI <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 'The applicant needs to contact their f DC Inspector to determine if rt permit is needed from themprior to <br /> .1tVY construction taking place fur any dwellings,dwelling additions,manufactured homes.manufactured z <br /> home additions,and bunkhouses.* <br /> !o <br /> x Fee Rec: 1,26O <br /> f � - Check#: <br /> 1 � m <br /> Date of staff site vis' : Init.,Is of site visit staff: z <br /> e <br /> APPROVED BY LAND SERVICES OFFICIA is /6 O <br /> n r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a 'c c Jun"n�+l <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° dPO <br /> `C y W <br /> Transcendent: - _ Page 1 of 4 c N.,Lasertische: Burnett County, WI Land Use Application—Rev 6/2020 ` -'' Q <br /> I <br />