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• <br /> LAND USE PERMIT APPLICATION- Burnett County, WI r <br /> - b <br /> v–, 0 N <br /> Applicant Complete All Sections Below This Line 5zc o <br /> Permit Types and Fees:(Please,check appropriate boxes) a. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 O .4) <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 1&)*% / O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 & g <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ; <br /> Filling/Grading $150 Boathouse $500 r <br /> Six Month Camping Unit(One Per Year)) $100 Permit Extension(lYear Extension-Allowed Once) $100 <br /> cn <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. • i <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. i <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. %fo I' <br /> L 9, <br /> Property Owner's Name: �0 p- a'r 6 VV ^r,,nJ <br /> Property Owner's Mailing Address: /.02 to 5 "ecTv, - 4.0%L' 4/1-.0�- o L <br /> Property Site Address: ,j �„... City State Zip <br /> p T��3 �l 5/���T-� 17�.v.li�✓y 1 S Gl g 3c� c <br /> Contact's Telephone Number: 6./P4/ sz� -- `j i/2- o �� <br /> / o <br /> Contact's Email: c,6ciGl/'q G'j j o bo/C� v,fideir, co/itb <br /> 11 Q <br /> 5' <br /> Legal Description of Property: <br /> N -c <br /> Section#: D.-D Town#: 40 N Range#: L(... W Town of: ° ° <br /> 5' <br /> tic*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property tyPage.* <br /> d <br /> Tax ID#(1-5 digit number; found on tax statement): '3'36 iv <br /> Proposed Use of Structure/Addition: !7 ow. <br /> Anticipated Start Date: o v <br /> �!®/ �Q (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) E x <br /> ▪ d <br /> Building Contractor: /9,4/' edict //c ioo...S Sewer Installer: b ee,/4-l,(,Ji- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT 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 c-- <br /> ANY construction taking place for any dwellings,dwelling additions, manufactured homes, manufactured z <br /> home additions, and bunkhouses.** z NO <br /> -- Fee Rec:3OO <br /> 42D— <br /> U Check#:( lie28e <br /> C <br /> -- n <br /> Date of staff site visit: 40 0.. � . s r f site visit staff: z <br /> o J �� <br /> APPROVED BY LAND SERVICES OFFICI• : . IP DATE:7 !j-9yo rn <br /> rn �� f <br /> A a <br /> UPON APPROVAL: APP ICANT MUST POST COPY OF CD <br /> a o W r <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° g� 00 <br /> Q. <br /> Transcendent: Page 1 of 4 rn 3 <br /> Laserfische: Burnett County, WI Land Use Application—Rev 6/2020 m ? [� <br /> c <br /> a <br /> K <br />