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LAND USE PERMIT APPLICATION—Burnett County, WI crc <br /> rn Applicant Complete All Sections Below This Line o c o <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> rI <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150Addition/Alteration to Accessory Structure $150 I <br /> Accessory Structure(Commercial/Industrial) $200 'Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 _ Permit Extension(1 Year Extension-Allowed Once) $100 t%_ <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. tS <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. , .SM— <br /> *ltems not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc.wihg ll <br /> Property Owner's Name: '\ 0yyr-A..- I m. it i'y -S z <br /> IP <br /> Property Owner's Mailing Address:_ ?3. P,(1s` r!cai eWQ.IJ f€v �l si f 9'4 o <br /> v r <br /> Property Site Address: 77 <br /> 1 ,city Stec, Zip <br /> ipM �� 1 .1 .1 lv,49 ^ (AiSi/ <br /> �3 C E' n ` <br /> Contact's Telephone Number: 745 -3( p�G 7f �^ o K <br /> Contact's Email: M Ane„/'J 2.6 C ! /Y I q 11 l s CO t►" l d <br /> Legal Description of Property: L 0 t 71.5 j o O&. V 5 P L .7 <br /> N `O <br /> Section#: 35 Town#: 4 i N Range#: i 6 W Town of: S W 1 SS = °a <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): Q 4 3 70 a. <br /> 1):11+..1 <br /> Proposed Use of Structure/Addition: } cj"�"1 p "' <br /> Anticipated Start Date: I)Crne/ d (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o x <br /> 6 <br /> Building Contractor: n ick Sewer Installer: n I a <br /> y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: c k) <br /> po 0 <br /> Fee Rec: 1025- <br /> Check#: �� zi <br /> Date of staff site visit: (/'�/� niti of ite visit staff: <br /> vR "� a <br /> Q o <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: --Lf- Q 1 r <br /> ,,, <br /> mBOJ <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 �n7 <br /> Transcendent: - Page 1 of 4 En u u u <br /> ww <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 6/2020 oi v v <br /> co o WO <br /> .co \=.) <br /> tea.-. <br />