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• <br /> LAND USE PERMIT APPLICATION— Burnett County, WI a <br /> o . N <br /> Applicant Complete All Sections Below This Line ° co <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <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 ei' <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n Ks <br /> (� <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 $' <br /> Filling/Grading $150 Boathouse $500 <br /> o is <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 n <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. ,. <br /> Property Owner's Name: C41 - ter, r g. • <br /> '11z <br /> �I <br /> Property Owner's Mailing Address: 9- '1--c7 0 ry ,q--- o <br /> /, City State Zip <br /> Property Site Address: '� -!� '�' S'27 n <br /> Contact's Telephone Number: l / C' ��7 C- U' / oy <br /> • C <br /> CD <br /> Contact's Email: C L g ��j Db�j )04-00, C '1 - d <br /> Legal Description of Property: Z- GSG✓) Vt a T , ..7/ / ., <br /> N ^o <br /> Section#: 2, // Town#: it-0 N Range#: ( � W Town of: Gm7r-- o °a <br /> 5. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system properly page.* o <br /> 33 Tax ID#(1-5 digit number;found on tax statement): 723 <br /> Proposed Use of Structure/Addition:- 'V F' L_ C/' <br /> Anticipated Start Date: / (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o x <br /> 0 <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LLNE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY W <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 J <br /> ANY construction taking place for any dwellings, dwelling additions, manufactured homes,manufactured z <br /> home additions,and bunkhouses.** 70 N <br /> - <br /> ► /+�7 -) <br /> .----7 T its c,lis"lif 9 TV Sa S F� f1e" i N/vL°-#.'t P,"LT <br /> a s fi'sd %,i C 6(P-o-i6 4vlI 4uP-Zo-s'9c <br /> ( e vev-%.I - `t so tA/ v1(,J 47L b 4//ch") = Fee Rec: �U�a" <br /> y Check#: /7Z L' <br /> / o <br /> Date of staff site visit: 7/2-2-720012 /'Initials of site visit staff: j/ z <br /> ll! <br /> APPROVED BY LAND SERVICES OFFICIAL:79 < d <br /> /v"" - DATE: 9 a002O <br /> 1/ r17 0. Cn <br /> UPON APPROVAL: APPLICANT MUST POST COPY OFg)g3 r C <br /> m co <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° o o O° <br /> -8 _ ro <br /> Transcendent: - Page 1 of 4 m w'` c�.-ti, <br /> Laserfische: Burnett County, WI Land Use Application—Rev 6/2020ffi <br /> rra <br /> 3 <br />