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LAND USE PERMIT APPLICATION— Burnett County, WI <br /> Ft <br /> Applicant Complete All Sections Below This Line 5 cn o <br /> Permit Types and Fees:(Please,check appropriate boxes) , °' x <br /> d <br /> Dwelling/Principal Structure $300 x Addition/Alteration to Dwelling/Principal Structure $200 d <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 .._..cg 00 Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 .P <br /> , <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n 1 p.._/ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 l/ <br /> Filling/Grading $150 Boathouse $500 <br /> o <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> v) <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. 0 <br /> .�1�^ r 9 <br /> Property Owner's Name: AN) L - `1 11 e„.; c1 o o is <br /> Property Owner's Mailing Address:149 2_W t 37- S • j i Pie' MU I <br /> City State Zip -g- <br /> Property <br /> oProperty Site Address:'Vrej LILT l (2,1) lb/ E. <br /> Contact's Telephone Number: �1 — (0I`� '5;2, 1. •o <br /> Contact's Email: dfA l'eQ i rick Go, (� (, �Y► c 1 I "LoWI _� e <br /> Legal Description of Property: (?4 .IA(Z4ot not.) p 0 '_L 1.01-- 2 .. <br /> C14-1,0 /_ <br /> Section #:'-1-1102 Q Town#:'-�- Range#: W Town of: ,ZT�"� o Jo <br /> ac*Attach additional page if needed for lengthy description OR attach a copy othe deed OR attach tax system properlyPa e.* <br /> d <br /> Tax ID#(1-5 digit number; found on tax statement): (9- 1 6 <br /> Proposed Use of Structure/Addition: .A )Dian; .4--SeASO Li p op_c- `, <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ox <br /> Building Contractor: Sewer Installer: <br /> -s <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Z <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.** <br /> of POCCh gdd�-Fi or, no-E- -TheyCec- 0. COSh 0-c- <br /> �-�Y 3,1) 3 6D (ta bor. fi t'n0.'f'e f;a(3 l►1du c(ecf) <br /> Fee Rec: <br /> e Check#: <br /> Date of staff site visitl . C)11Gi`� Initi Is of site visit staff: D <br /> Z <br /> VAPPROVED BY LAND SERVICES OFFICIAL ---SATE: �-6 c c < rr <br /> n U` <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF > g co r <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° o a o <br /> Transcendent: - Page 1 of 4 0 N <br /> Laserfische: Burnett County, WI Land Use Application-Rev 6/2020 m j o <br /> a <br /> U <br />