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• LAND USE PERMIT APPLICATION- Burnett County, WI <br /> a <br /> Applicant Complete All Sections Below This Line 5' c <br /> Permit Types and Fees:(Please,check appropriate boxes) c <br /> A Fy <br /> Dwelling/Principal Structure $300 7 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 ;-,§. <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 II <br /> c NI <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o <br /> Filling/Grading $150 Boathouse $500 C. <br /> in Unit(One Per Year ° <br /> Six Month Camping g ) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aqui red 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 /> FC 3 <br /> Property Owner's Name: M l�Q�GtP(\ If\I�STt f' AtVton • <br /> Property Owner's Mailing Address: 2tf / I\J'Chor anti "R®J WLl kr L%'7 .Y f4( 3 o Ul (ZS, <br /> n ii � ` City State Zip ti <br /> Property Site Address:.�y3clifinejlerinn�'`�0 cA <br /> ,.Lkbs ice t ULC ,S•y 3 �' n r <br /> Contact's Telephone Number: 7 i �- J(c,6—OZ&C) o c r <br /> Contact's Email: Guth rtAh% AuLts e ne l-SCcpe j' o <br /> Legal Description of Property: <br /> Section#: " Town#: N Range#: W Town of: z °0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> Tax ID#(1-5 digit number; found on tax statement): r <br /> Proposed Use of Structure/Addition: CA <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o x <br /> o 5 <br /> Building Contractor: Sewer Installer: I , <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 1 <br /> home additions, and bunkhouses.** x <br /> I'7) , F (0-1- til. <br /> Fee Rec:xc ZJ— <br /> 4 Check#: 'F57/ <br /> tik <br /> Date of staff site vis' ��04 -, <br /> i is of site visit staff: z <br /> APPROVED BY LAND SERVICES OFFICI• DATEF--11r�ZCa° n _ <br /> ��� <br /> m � <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ; ,v '-a- • g; <br /> „ < „ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° a �� <br /> V <br /> Transcendent: Page 1 of 4 m C K a <br /> Laserfische: Burnett County, WI Land Use Application— Rev 6/2020 m = <br /> -3 C J <br /> K <br />