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LAND USE PERMIT APPLICATION— Burnett County, WI a <br /> b <br /> c.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 /> n <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,J NIR Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 Y O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c <br /> Filling/Grading $150 Boathouse $500 o ' • <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(l Year 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. w <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: VAPLL 44 st,ell AIX- z to <br /> Property Owner's Mailing Address: 2-7 54969 4,JCesv J 57 eifbria-- kiI 5Yeec 3 $ <br /> City State Zip <br /> Property Site Address: Sf'`MiC F. V <br /> V <br /> '' <br /> Contact's Telephone Number: T5,' q/t" /O 8 o r <br /> 0.. <br /> Contact's Email: bp°pE 4 M C VA-14-6u . Gal.& <br /> ro <br /> Legal Description of Property: TerF,e1 es e-,V f7 . LT(' 6L-14 2- <br /> N <br /> Section#: S3S32-. Town#:7 90 N Range#: R l(o W Town of: CA't 0. <br /> "q*Attach additional page if needed for lengthy description OR attach a copy othe deed OR attach tax system roPert1Pa e.* <br /> d <br /> Tax ID# (1-5 digit number; found on tax statement): /41 7/q T <br /> Proposed Use of Structure/Addition: S?6Q -Gya v) <br /> Anticipated Start Date: -i -� <br /> '. 2e Zo (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 3 x <br /> Building Contractor: Sewer Installer: /✓+14' 5 <br /> -3 <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 <br /> ANY construction taking place for any dwellings,dwelling additions, manufactured homes,manufactured Z <br /> home additions, and bunkhouses.** �( --1-61-°r` <br /> - NO-V Foc }�ww�A <br /> `(r\ v).-k.a c Pe t o - --k- b,8e se-E-bo-c-V- 4— <br /> go-N- rear se+&c11 <br /> -' Fee Rec: f • <br /> S' , Check#: 5'.3 9z <br /> Date of staff site visit: Initials of site visit staff: <br /> _ <br /> cri CD <br /> APPROVED BY LAND SERVICES OFFICIAL': r I ' <br /> 1 '�.-�`� ,�� ��'�— --DATE: �. � _ �.<., <br /> iiini <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ' . c <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT r o N <br /> Transcendent: - Page 1 of 4 "1: N Q <br /> Laserfische: - <br /> Burnett County, WI Land Use Application— Rev 6/2020 o <br /> 3 <br />