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LAND USE PERMIT APPLICATION- Burnett County, WI a <br /> Applicant Complete All Sections Below This Line a' CD o <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> A <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 v <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 j, <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 r <br /> C) <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 r � <br /> o 11 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> cn <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. ,2 ' <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. b -r <br /> � r ..0 <br /> Property Owner's Name: No-'R' �.tlhp Prpe,-if, .t t !-L. ° z r <br /> 9 110 <br /> Property Owner's Mailing Address: 3/12 IA-v.54 we 11 i,t.sx:. We,bb LP L4rsy oiu g ,„. <br /> ,.City State Zip ti111 <br /> Property Site Address: CCpitn h k I!' Lt i,L.. SL{2S'E (6 <br /> Contact's Telephone Number: 715-7g t `his- o E 's♦ <br /> 2. <br /> Contact's Email: 14 iGco"At// /n5010,e I , C c`'N d <br /> co <br /> Legal Description of Property: P..G 6Z, / f 2___, <br /> 0 00 <br /> ii Section#: 7/ Town#: if N Range#: /�p W Town of: (,041„, <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p <br /> fr <br /> Tax ID#(1-5 digit number;found on tax statement): 35,3 l g <br /> Proposed Use of Structure/Addition: RRN)n„1,f el F(-ccS,.,,; /,Z Cep`✓' '') <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) E x <br /> Building Contractor: 13.1"-e f4.fief' Sewer Installer: 0 t'•F <br /> 13.1"-e ir <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY r dk <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r -: <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to r-- '.,j <br /> Aa"Y construction taking place for any dwellings, dwelling additions,manufactured homes, manufactured z . ..-C.A <br /> home additions,and bunkhouses.** , W <br /> 'Mrsi wtt`1- 15 -Gr At cab/%1S S4ol)h opt Ls-Z4miLof3 op <br /> ir <br /> V 2 8 P7 39 - Dom# 1/635.3( <br /> P f 6 mor(„ foi <br /> �- � D✓'ditiaHc�e.-. 30 -6 77 crrlif- ex�►a �-'� � y 4h Zs-A <br /> — Pee ONw6 NQ fe.- 'lc- (IP ce"A f ee fl4t e, wiov - i1q s4 Sd.Z m )1/4e_ FeeRec: _ ' <br /> 5 ret 1 eo Inn el evt fS, U Check#: ti4ii 7 <br /> Date of staff site visit: S /u '2'674' Initials of site visit staff: J7.---- <br /> ,cJ L_JI <br /> APPROVED BY LAND SERVICES OFFICIAL: BATE: O Z7 W i 1 s.._ r <br /> C= t© <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF31 <br /> 00 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT a <br /> �3 <br /> a <br /> Transcendent: - Page 1 of 4 r Uw <br /> Laserfische: - Burnett County, WI Land Use Application- Rev 6/2020 < , , <br /> 3 <br />