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LAND USE PERMIT APPLICATION — Burnett County, WI r <br /> b <br /> "' N <br /> Applicant Complete All Sections Below This Line 5* '' 0 <br /> Permit Types and Fees:(Please,check appropriate boxes) d a t� <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200m <br /> 0 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `-O <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 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 C) <br /> \ <br /> l <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 Ai <br /> Filling/Grading $150 Boathouse $500 r+ p <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> CA <br /> *NOTE:After-the-fact permits(permit squired 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 /> -TO S^'► C 1.,n t C n o . <br /> Property Owner's Name: It <br /> c, <br /> Property Owner's Mailing Address: <br /> `'� 1a Xenta. Ave ki o <br /> p ( CityState Zip a. <br /> Property Site Address: Ca O 9 0 11 cA- (leo. i 61(e ed Pant u.v I <br /> G i E <br /> Contact's Telephone Number: 12 7 / o <br /> Contact's Email: i^ ( .2. (.5-1C Q CC i-n c7 <br /> Legal Description of Property: <br /> i—a t S CS I.tt L4 13 V 24' Q 2 13 <br /> CD <br /> N b <br /> Section#: 3 `a Town#:`t IN/ N Range#: i to W Town of: S i..L% 5:•5 0 00 <br /> 5 <br /> r <br /> *Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system property Page.* <br /> C <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: 5 t C 'f a- y .e v, <br /> Anticipated Start Date: i 0/ a-4 •,4 se (Home/Cabin;Commercial Business;Bedroom;Deck,,etc.) o x <br /> Ei <br /> Building Contractor: N rc <br /> Sewer Installer: µl R <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY E <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: �' �f <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to t OQ <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** %° <br /> _-- I n n. /6 F-1-- �;de 5 b '' - <br /> rr proler*1 L,,t s Fee Rec: / <br /> o <br /> Check#: c2tb(p <br /> Date of staff site visit:l0��/ �p�� Initial f site visit staff: �Vl� <br /> z <br /> 0 <br /> 2 . ' <br /> APPROVED BY LAND SERVICES OFFICIAL: `y�� ° B • E: /0^r� J= *0- d" < �� <br /> Fi <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a a CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTr" 0 <br /> - N n <br /> Transcendent: - Page 1 of 4 r W; n,,2, <br /> Laserfische: - <br /> Burnett County, WI Land Use Application — Rev 6/2020 c::: <br /> < r <br /> C:7 Wifirg <br /> y w <br /> a <br />