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• <br /> LAND USE PERMIT APPLICATION- Burnett County, WI ',..-;'4 <br /> c <br /> pz <br /> Applicant Complete All Sections Below This Line _ c CP <br /> Permit Types and Fees:(Please,check appropriate boxes) iy a 6' <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 /> .-_,,, <br /> A Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure _$150 � <br /> � E <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 I 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk _Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692)ly)Structures $350 e b <br /> Filling/Grading $150 Boathouse $500r- , <br /> Six Month Camping Unit(One Per Year)) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. LD <br /> 1 *Communication Towers&Signs require a different application form;see corresponding application,and fees. i <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> r g <br /> Property Owner's Name:M tkE. L I✓(E.I� l z '-. <br /> 0 <br /> Property Owner's Mailing Address: /622,1 W e5 f /f4Q d( C (✓Le 64 b b r 1 ✓€ § I <br /> City State Zip o ' <br /> Property Site Address:Z)7 ZS I, A t'�'z Pill E. T I.- 7'routIn MN <br /> `� y <br /> FrrdG.rt c, i i S44 93-7 ^� �r 3 <br /> Contact's Telephone Number: ( !1'r KL' 1' I Z 2 g O 9 044 -7 o N <br /> Contact's Email: cS'� J v M p�r\f--00( C jr1',Ct 1 ` - �v 13'I d n <br /> r j <br /> L SP(r , t Lull <br /> Legal Description of Property:L.U•+ I fjl I�Iu fo- Wit tsrer ivtcl P,(,LF$S OF r <br /> .J1 / N o0 <br /> Section#: 0 i2—Town#: 3-7 N Range#: I W Town of:rruacev .. See q i - <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p <br /> Tax ID#(1-5 digit number;found on tax statement): 33 3I S 5. <br /> Proposed Use of Structure/Addition: Gcv>(c9-- v' <br /> l�Jo m <br /> Anticipated Start Date: Home/Cabin;Commercial Business;Bedroom:Deck:etc E x <br /> Building Contractor: Seg Sewer Installer: <br /> G <br /> -o -..\ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY .P S-)%1 <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 /> 00 <br /> home additions,and bunkhouses.** 70 <br /> 1\1(fy 0falek <br /> Fee Rec: I`5C <br /> . Check#: /levo <br /> Date of staff site visit: 7-1 '90,?:) Initia s of site visit staff: tj\ crz <br /> to <br /> APPROVED BY LAND SERVICES OFFICIAL <br /> DATE: ^Cr < art <br /> nEfil <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF g <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT -2 N TR <br /> pC <br /> , PV <br /> Transcendent: Page 1 of 4 N <br /> Laserfische: Burnett County, WI Land Use Application-Rev 6/2020 <br /> a <br /> L 1 J <br />