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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> b <br /> Applicant Complete All Sections Below This Line g =' o <br /> Permit Types and Fees:(Please,check appropriate boxes) .. 7 <br /> + Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> i,Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ".••J <br /> (Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150Q 9 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 _ 54 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 !� n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 I o <br /> , <br /> Filling/Grading $150 Boathouse $500 r- U I <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 (1 <br /> cn lb <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <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: M idAta-C, 44,-e....„ , ..o <br /> Property Owner's Mailing Address:110(U P z c ZR Svx ,,,ie;/ kit o -( $ a_ <br /> d City State Zip <br /> Property Site Address: S �( <br /> • <br /> Contact's Telephone Number: 6: )-`9g( .—GM r <br /> CD <br /> Contact's Email: SC,0011.6Cev`1`,j Ny t;vtk 1 (A—Ct. 0 d <br /> to <br /> Legal Description of Property: V" 1? S /a, 5 )(cZ. 5 /V v <br /> i J C r- <br /> *Attach <br /> ection#: 5i) Town#:VOJNRange#:gli✓ W Townof: )(b i additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> '] 4 <br /> Tax ID#(1-5 digit number;found on tax statement): 33 d-ci a' <br /> Proposed Use of Structurre dition: S (`� (, <br /> Anticipated Start Date: ��7 <br /> y0 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 1 o <br /> d <br /> Building Contractor: 1".6/"S©v ..... -.0 Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY L� <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.** Po <br /> 06A-- V o vvtalA410-i-\--4-41\c41 <br /> 1 <br /> x Fee Rec:' I 0 <br /> Check#: c)24), b <br /> 7e—c9`a-0X) �� o Cam-,b.'•a r <br /> Date of staff site visit: In' 'als of site visit staff: MZ tiifstfle J S.1a53 <br /> APPROVED BY LAND SERVICES OFFICIAL ATE: <br /> 7 3- ° �- <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF aW 14 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ; o o �, z <br /> Transcendent: Page 1 of 4 n °- N <br /> Burnett County, WI Land Use Application —Rev 6/2020 — <br /> Laserfische: - ii <br /> a m <br />