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LAND USE PERMIT APPLICATION— Burnett County, WI a <br /> Applicant Complete All Sections Below This Line ° '' c <br /> Permi Types and Fees:(Please,check appropriate boxes) "' <br /> C7 <br /> , Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 CDw <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 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 :; <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 qi <br /> 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 a. pry <br /> Filling/Grading $150 Boathouse $500 °r I <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 'a <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. F <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. <br /> Property Owner's Name: Rea erk f u r^di,-/) K LOC' <br /> Property Owner's Mailing Address: F 0l fen kjel WQ6r°`— a i -j %'7f 8 C� , <br /> l d City State Zip 0 11 <br /> Property Site Address: '7/ 7 <br /> Contact's Telephone Number: � 7 g` <br /> CD <br /> a. <br /> Contact's Email: 6.i,+'., ya he` Ce' d <br /> Legal Description of Property: /VC ,V t <br /> N b <br /> Section#: I/ Town#: 3? N Range#: / W Town of: L in c 04 . <br /> cro oz <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page.* 1:7 <br /> Tax ID#(1-5 digit number;found on tax statement): /Q Se ? 5. <br /> Proposed Use of Structure/Addition: Horn 12' <br /> Anticipated Start Date: S�,o/`• -2 S (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) -..1 E <br /> Building Contractor: Kira Pit t`Qrj(i Sewer Installer: /Ile f" •%►i y 1-- <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 /> `' <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured Z <br /> home additions,and bunkhouses.** <br /> r /� Ure- all S aokS g!r'I✓ !tit""' ' <br /> /' �A 5 <br /> q/ suk. bIA i�N I°e/rIA.4,tPc71Ay4 <br /> uloc (e7 5, Fee Rec: <br /> 6 Check#: <br /> r <br /> Date of staff site visit: Initials of site visit staff: / 8 <br /> TE: 7/z0- 7e S r <br /> APPROVED BY LAND SERVICES OFFICIAL: rr <br /> Uu <br /> UPONcii <br /> APPROVAL: APP CANT MUST POST COPY OF W C <br /> _ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o o o 00 5 <br /> CDC !N.)Transcendent: - Page 1 of 4 =. r-..., <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 6/2020 t4i 3 <br />