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, <br /> cn ti to <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> cn <br /> Applicant Complete All Sections Below This Line s' o <br /> Permit Types and Fees:(Please,check appropriate boxes) n <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <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 q` i <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 n 0 r <br /> Filling/Grading $150 Boathouse $500 9.7 <br /> h <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. F. L <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 /> R. <br /> Property Owner's Name: o <br /> Property Owner's Mailing Address: __ _ _ $ <br /> City State Zip .o <br /> 111 <br /> Property Site Address: at 5. v <br /> 4 <br /> Contact's Telephone Number: —_ _ or <br /> ° c <br /> Contact's Email: 0 © a <br /> Legal Description of Property: <br /> N .0 <br /> Section#: _ , Town#: N Range#: W Town of: 8 °C <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system properlypaBe.* tdc <br /> Tax ID#(1-5 digit number;found on tax statement): g' <br /> cr <br /> Proposed Use of Structure/Addition:_ <br /> H H <br /> Anticipated Start Date:__ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o <br /> d <br /> Building Contractor: Sewer Installer: <br /> H _ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Ili6,1 <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.** M <br /> 0 eFo \60 ��e PVC - fAcor\ <br /> . ,c( 0,-, ,,,--\ e"---, , ... <br /> \o .v._.1,_ ,,,,)„ e---\--- ,„,d.X...-k- Ct V10 <br /> Jac_-PPro rr\ Q-A_ of dp <br /> 6 on 4v• neCS Sere �0.6' ne -�'� PcsvaTe e� x Fee Rec: i�O— <br /> T 9 �c rS Check#: 5 !O <br /> ..--- <br /> -7,..../ L, O <br /> Date of staff site vis /�� nit a of site visit staff: <br /> IV <br /> 6 <br /> m <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:?—P-r'--,?-0(30 < <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF y m <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z " a <br /> Transcendent: - Page 1 of 4 P v 0 c,a rn <br /> Burnett County, WI Land Use Application—Rev 6/2020 = cD = +u '� <br /> Laserfische: - PP d ` ✓�) Q <br /> U (� <br /> mUVU <br />