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LAND USE PERMIT APPLICATION — Burnett County, WI a g t� <br /> Applicant Complete All Sections Below This Line 0o o <br /> Permit Types and Fees:(Please,check appropriate boxes) n' g <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ?; <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 •0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 q <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 1 <br /> io <br /> Drveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 g <br /> Filling/Grading $150 Boathouse <br /> $500 r, <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 <br /> En <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. .. W. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. 9 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. I <br /> Property Owner's Name: 1044 Wl sf' 44/4(/'Ji S z <br /> 9 lb <br /> �i l a kilo LMJL.- �a 41� <br /> Property Owner's Mailing Address: tBSfi to lS3 on <br /> City State Zip ' <br /> Property Site Address: -. <br /> cn <br /> 7tS SS 3 -ii <br /> Contact's Telephone Number: o y <br /> • c <br /> 0.CD <br /> Contact's Email: 4"i Wi. G''&k.1 N S i 3-- e 1444-7c /� - d <br /> w <br /> g <br /> Legal Description of Property: ,. <br /> N <br /> Section#: ITown#: N Range#: _ \W Town of: I ' 'n�)r <br /> ao <br /> � <br /> *Attach additional page if needed for lengthy description OR attach fa copy of the deed OR attach tax system property page.* u. <br /> Tax ID#(1-5 digit number;found on tax statement): 1'01 0 <br /> Proposed Use of Structure/Addition: e J,, <br /> ,-3 H <br /> Anticipated Start Date: 9/2 t 2(-1'f- (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ox <br /> 0 d <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY r <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: CA <br /> ,A <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to d <br /> A:VY construction taking place for any dwellings, dwelling additions, manufactured homes, manufactured z <br /> home additions, and bunkhouses.** z <br /> z Fee Rec:h:26-1-9- <br /> 7 <br /> / Check#0i 33 <br /> 0 <br /> ���� rl <br /> r <br /> Date of staff site visit: ��� ��4Initials of site visit staff: z <br /> r <br /> APPROVED BY LAND SERVICES OFFICIAL: , ATE: 9 `-7,s,04w, . R <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a m E 0 <br /> :, <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° o 00 <br /> Transcendent: - Page 1 of 4 xi co <br /> Lase sche: - Burnett County, WI Land Use Application—Rev 6/2020 m et <br /> WI <br /> H `�=� <br /> K <br />