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LAND USE PERMIT APPLICATION- Burnett County, WI a `° <br /> < b <br /> Applicant Complete All Sections Below This Line 0 o <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> ,( Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d . <br /> co <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 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 R <br /> - <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 C� <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0< <br /> Filling/Grading $150 Boathouse $500 r 6 pi, <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year 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. k % <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. E. til <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: 6.47 1,...4 S lc) .4. co!'t_5Til c e u h c, t 4' Pt z <br /> _5-4183u ,h c <br /> Property Owner's Mailing Address: '6'j'6C� C c c /7‘,/ aryl L-4 es. I01 . <br /> City State Zip <br /> Property Site Address: 5) 7C 3 C7/ ,— ./ 4) , s.7 -7 W.:[ S ii'r�r�' E.' n r„, <br /> i• <br /> Contact's Telephone Number: 6 O 6' -- 3 y - _5 6-..-/y o N (Q <br /> a <br /> Contact's Email: C c A v ct All ca 1'r 0� l'rJ- ' N -, ec,,-n o <br /> Legal Description of Property: /Y CO /7y" c,-Fs-L C TI i c' /Y E 0 i le <br /> Section#: // Town#: 3 9 N Range#: / 7W Town of:_g /Pt e c Ik °Q 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 /> 14 <br /> E. <br /> Tax ID#(1-5 digit number;found on tax statement): /0_5—C) '`7/ <br /> Proposed Use of Structure/Addition: O / t <br /> Anticipated Start Date: e//,j ,. C� (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 0 x <br /> �/ d <br /> Building Contractor: /I`e u-,.�7 , 74 /Y r,..71 Sewer Installer: gos, /u IG:N e/F c4 H .- <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 u permit is needed from them prior to <br /> .4ATV construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z ^t- <br /> home additions,and bunkhouses.** x <br /> Fee Rec:3(o� <br /> ri Check#:�jie/i) <br /> rt <br /> Date of staff site visit• P-0 Initials of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICIAL: 1. ri <br /> rt <br /> y�� � -' --_ DATE: 7—�'� <br /> 0 <br /> Fs <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF yL lair <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT f g r <br /> Transcendent: - Page 1 of 4 g c <br /> Laserfische: Burnett County, WI Land Use Application — Rev 6/2020 r3 Z 1 cc: <br /> ��' <br />