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LAND USE PERMIT APPLICATION—Burnett County, WI a b <br /> �• '» N <br /> Applicant Complete All Sections Below This Line c <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $3001 Addition/Alteration to Dwelling/Principal Structure $200 o <br /> Commercial/Industrial Structure $3001 Addition/Alteration to Commercial/Industrial Structure $200 � CS\ <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 -9 O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 CD <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <° (J <br /> a <br /> Filling/Grading $150 Boathouse $500 S" V <br /> Six Month Camping Unit(One Per Year) 1$1001 Permit Extension(1 Year Extension-Allowed Once) $100 <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. CD <br /> Property Owner's Name: + h O 011 LL S 00 f�z <br /> 0 <br /> Property Owner's Mailing Address: c ) , I:Z.'!�l<>-��-r i� i I P � t ' �V rl <br /> City State Zip b <br /> Property Site Address: <br /> —7 y l _ l � <br /> Contact's Telephone Number: / / �� E��f� / �'G ��''I� yni) ° N <br /> J <br /> g <br /> Contact's Email: /)G j,• )jL S C C�ej �3 c� <br /> Legal Description of Property: L� f, ! C) °i� `'N1 f kkox r..,• i �' --s K C <br /> Section#: Town#: N Range#:� W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* t7 <br /> Tax ID#(1-5 digit number;found on tax statement):_ = <br /> Proposed Use of Structure/Addition m: o la r ill L d u f e IP o C 1 i <br /> , <br /> Anticipated Start Date: t ' : (Home/Cabin;Commercial Business;Bedroom;Deck)etc.) <br /> C' l d <br /> Contractor: _& -i C.�✓ -�;) d Y', _L(-- Sewer Installer: <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 <br /> home additions,and bunkhouses.** X <br /> Fee Rec: <br /> 4 Check#: 3-7 / <br /> Date of staff site visit: Initials of site visit staff: > <br /> 01 <br /> r � .v <br /> APPROVED BY LAND SERVICES OFFICIAL: w <br /> • T COPY OF ro�' ' <br /> UPON APPROVAL. APPLICANT MUST POST � <br /> T APPLICATION IN PLAIN SIGHT j-3 [;—j. <br /> SIGNED PERMIT Transcendent: - Page I of 4ID <br /> Burnett County,WI Land Use Application—Rev 6/2020 <br /> Laserfische: --'�, <br />