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• <br /> LAND USE PERMIT APPLICATION- Burnett County, WI <br /> B b <br /> Applicant Complete All Sections Below This Line o' c o <br /> Permit Types and Fees:(Please,check appropriate boxes) ° g, <br /> Dwelling/Principal StructureC7 <br /> $300 Addition/Alteration to Dwelling/Principal Structure $200 ?: ‘Ni <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `' <br /> /X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 a 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 4•- <br /> '� <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 lj+ <br /> Filling/Grading $150 Boathouse $500 r % <br /> Six Month Camping Unit(One Per Year) $100 _ Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-factermits <br /> p (permit aqui red after construction has begun)may cost up to three times the normal fee. t <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. w <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,Ian soaping,etc. q.o <br /> /�/_ L • <br /> • c CD <br /> Property Owner's Name: l✓7T ` `j: S j �j�-� <br /> z <br /> 0 a <br /> Property Owner's Mailing Address: X/C/NC' &f. ,)wp ,4 iii 53/V6 o <br /> Property Site Address: C/r�� id ie___ ir,t,y ASNe Zip o <br /> Contact's Telephone N ber: & /2- g.(6 / 7 fe/ 7 o y <br /> E. " <br /> AContact'sS Email: ''.- / / U S�iyj�%�- .5 -7,1 : r is <br /> Description of Property: L®, CS j 1A..,.:3 '&7 ( 37 )évs <br /> -0% — <br /> Section#: N n <br /> 27 Town#: 9/ N Range#: /c W Town of: 50//,S ' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* as <br /> b <br /> Tax ID#(1-5 digit number;found on tax statement): 3 2- 7 8**t <br /> Proposed Use of Structure/Addition: ,. . �, <br /> Anticipated Start Date: �P,;l�- (Home/Cabin;Commercia Business;Bedroom;Deck;etc.) o x <br /> ��� _ <br /> Building Contractor: Sewer Installer: d <br /> -- VI. 04 <br /> AREA BELOW THIS LINE FOR LA 'D SERVICES STAFF COMMENTS/CONDITIONS ONLY 2 b <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: . 1 <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> .4:VYconstruction taking place for any dwellings,dwelling additions,manufactured homes, manufactured z Tr <br /> home additions, and bunkhouses.** f—'0c- 4tX,WICI k&- Pv <br /> E Fee Rec: L5O'- <br /> Check#: C'p46 <br /> Date of staff site vis Initials of site 4.it staff: > <br /> `� <br /> � <br /> APPROVED BY LAND SERVICES OFFICIAL: G�lti DATE: — �= r- <br /> .. m <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF c <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT oar <br /> 11 <br /> .I o <br /> Transcendent: - Page 1 of 4 n t a <br /> Laserfische: MI <br /> Burnett County, WI Land Use Application— Rev 6/2020 �`� `'' <br /> [ ci <br />