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cin 'v r• <br /> LAND USE PERMIT APPLICATION - Burnett County, WI c b <br /> Applicant Complete All Sections Below This Line 5' c <br /> CD <br /> Pe reit Types and Fees:(Please,check appropriate boxes) -- <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> ... ,...F.4A <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 0 <br /> 1 Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> C') <br /> Driveways/&CampgroundStructu_res $125 WI State Statute 59.692(1v)Structures $350 o <br /> ., Lk\ <br /> Filling/Grading $150 Boathouse $500 - <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year 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. q <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> r <br /> — ( <br /> Property Owner's Name: /e6i w,.,4! 44w,4 ( o,e.10 Pe-/GI o <br /> Property Owner's Mailing Address: 2 5-G $1 li*wk f _/(/�s? 0/ tWC Spy °o <br /> City State Zip o 1 <br /> 07 Property Site Address:Z,65-5-..44f.4.4, „(/vt f 40e1. 4•,.nbri j , Wt fY g'3 0 Z cn <br /> Contact's Telephone Number: G /Z - Sit - Z fG'f 1/1 Ai I 0 /0(.{.P--@ 5 er,}/ ,COryk F <br /> a. <br /> Contact's Email: J� , Pte.0e/pleg r d e. G</t6,4 05.te. /'/tG . Goas., <br /> Legal Description of Property: P.diw,(r s 4/44.' ,461 i v,f• 4v vi t L.t `zj I <br /> Section#: 15 Town#: 1-f 0 N Range#: 1 ‘ W Town of: ...I 4 or <br /> S. <br /> *Attach additional page i neededfor lengthy descri tion OR attach a copy of the deed OR attach tax system property page.* <br /> * `� <br /> P S f P �✓2 1 P P h P g P. <br /> Tax ID#(1-5 digit number; found on tax statement): 7 J .J/ j <br /> Proposed Use of Structure/Addition: G-a.res� "' <br /> o w <br /> Anticipated Start Date: WA:,/e.0 Z.& (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) g x <br /> Building Contractor: Sewer Installer: ,� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 1,1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **The applicant needs to contact their('DC Inspector to determine if a permit is needed from them prior to % iki\ 0,) <br /> ANY construction taking place for any dwellings,dwelling additions,manu factured homes,manufactured <br /> home additions, and bunkhouses.** x ��. <br /> ir.Q--) 61 fr-or A/1/0 0 gPfedie-ii <br /> = Fee Rec: /67)" <br /> 4 Check#:_!O S5 <br /> rt <br /> Date of staff site visit: 7-162 .�L/6)0 Initials of site visit staff: AlL z <br /> ic <br /> APPROVED BY LAND SERVICES OFFICIAL: 7 - �s <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF .coy VA01 <br /> c, , <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o o <br /> N C tV <br /> Transcendent: - Page 1 of 4 ,.22,- ,<•a N ` <br /> Burnett Count WI Land Use Application— Rev 6/2020 , otrial <br /> Laserfische: - Y' PP <br /> .,n <br />