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LAND USE PERMIT APPLICATION- Burnett County, WI a <br /> Applicant Complete All Sections Below This Line s o <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> -. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 m <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 ,T-() <br /> XAccessory 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(ly)Structures $350 <br /> II <br /> Filling/Grading $150 Boathouse $500 r I' <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 _ Permit Extension(l Year Extension-Allowed Once) $100 L. <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. ii <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> r 'i U <br /> P perry Owner's Name: C, ( - so./11 z <br /> Property Owner's Mailing Address: 2// Pit/I&'19 0 komfr 5_i $g J '71o <br /> 0 <br /> P&4 <br /> City State Zip fa. , <br /> Property Site Address: 3j' 2,9 L�0u�,� P&4 /'"/�� cediju,vf_o �ya'D j <br /> k) <br /> Contact's Telephone Number: 7 l5 -- 5 ^ 71.-L / o F <br /> Contact's Email: C 1--1-</1C 15o4-6-- Z‘:.( //44.,1-0 d , l,// a <br /> o <br /> egal Description of Property: 2.-4071-0 t`v/ U- Z 3/V <br /> Section#: 2— o -o <br /> Town#: �t� N Range#: l W Town of:_5(,0_17Ltl0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of thedeed OR attach tax system property page.* d <br /> Tax ID#(1-5 digit number; found on tax statement): 537 7-7 �. <br /> Proposed Use of Structure/Addition: _47/Or e— v] <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) IDF x <br /> Building Contractor: Sewer Installer: 1 -3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMLMENTS/CONDITIONS ONLY \ \ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: W <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to W <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkhouses.** %n <br /> --3 5e co %4bvtS u/ 4/ 6 u la-zo-36 tc)tik.,A <br /> c,47/ he,ext ,zev be; w, . <br /> —4 S,q„ls 74►, be- 4r ',TAf /:i/��o co0.1,4'nc y /aNzozo. �, <br /> d /9- I/ r e0 'o /!�t /!�1 W es 7'L. = Fee Rec:�oC, <br /> LCtK CSE G/"Iv1 O 4/N 2, sora <br /> .builete•, toy loll/ aozo. ° C_aSA <br /> Date of staff site visit: 7/2.2/20W Initials of site visit staff: J,7,- 2 <br /> 0 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 9/i I7ZO Ze9 t <br /> a1 <br /> �„ 11' <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF II <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> 0 <br /> Transcendent: - Page 1 of 4 1 1 Q <br /> Laserfische: Burnett County, WI Land Use Application— Rev 6/2020 PO <br /> L <br />