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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI 64, <br /> Applicant Complete All Sections Below This Line 5' c <br /> Permit Types and Fees:(Please,check appropriate boxes) °- <br /> A py <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 i til <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 O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 R) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °e <br /> Filling/Grading $150 Boathouse $500 <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. F.t <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: 6.. i(Y1 1/' 3a.&ee. o <br /> .71 <br /> Property Owner's Mailing Address: 2L )L4 6 rP'n -P �Jd Pot S/ OQ a <br /> Q City State Zip o <br /> Property Site Address: 2V)' Green P7acv L.c . w <br /> Contact's Telephone Number: 1)5— 5DD—111' ""- ___ <br /> Contact's Email: £ fnr.,Lj 4 to ha mat /e e-o/r1 d <br /> Legal Description of Property: Lv-" / (,S/1 - //3cA V ."P3 gcl ( ss£, <br /> Section#:3,2 Town#: 31 N Range#: 1g W Town of: Rusk . <br /> ug <br /> 5' <br /> *Attach additional page i needed or lengthy description OR attach a copyofthe deed OR attach taxsystem properly page.** P <br /> P S .f f S Y P P P tYPS p <br /> Tax ID#(1-5 digit number; found on tax statement): /693(9I a• <br /> Proposed Use of Structure/Additio�}: � r e /pailD e)Anticipated Start Date: /0//C/ 2OaO ome C in;Commercial Business;Bedroom;Deck;etc.) o x <br /> e3 <br /> Building Contractor: -�/f' Sewer Installer: -3 r d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ^ic, <br /> `.dThe applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to '` X, <br /> .4Nl'construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> Iwine additions,and hunkhous•es,** 4tAvAct <br /> �^c � Po <br /> � -� -F 5r v\ fl�yJ f J ` <br /> . o <br /> ..._ ..w <br /> g Fee Rec: <br /> N Check#: <br /> rig-- <br /> d <br /> Date of staff site visit: /V IX �(� Initials of site visit staff: JO O C2 <br /> APPROVED BY LAND SERVICES OFFICIAL:\""0 KTE: /e;"--- 7^;ar) - G-"'�" <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF . m <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Transcendent: Page 1 of 4 n w <br /> Laserfische: Burnett County, WI Land Use Application —Rev 6/2020 g <br />