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• <br /> LAND USE PERMIT APPLICATION-Burnett County, WI k <br /> Applicant Complete All Sections Below This Line o o <br /> Permit Types and Fees:(Please,check appropriate boxes) °' <br /> d <br /> Dwelling/Principal Structure $300 (Addition/Alteration to Dwelling/Principal Structure $200 t v <br /> CD <br /> Commercial/Industrial Structure $300 X Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 / Addition/Alteration to Accessory Structure $150 p� 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $ `2-0 � _ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° 1J a/ <br /> Filling/Grading $150 Boathouse $500 E Z <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year 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. g. p- <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. ,I� lip <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. a IS <br /> Property Owner's Name: -- -�O ) t j 'PA teal t.4h S z <br /> 11 <br /> Property Owner's Mailing Address: 7,9-4)9r„ „oilei • ..I)H,r/but L.J1 C1/7_?fS> 8 <br /> ��/ t� City State Zip <br /> Property Site Address: 7 a c,y, i(' - 'Q.i,6 cr i y Lt<t <a 0 17• <br /> � k <br /> Contact's Telephone Number: „9._g -_14 3-9€ c/67/G ‘ --BIOS/) o c <br /> Contact's Email: a4/cy u y7 d a u 1 dco <br /> o /4AOd. ('_o1y1 ) <br /> Legal Description of Property:/2'Ce) R.// sec_oz.-i fo,„/t f1� yl/i/`,eutP /1 to o <br /> VV N .1::Section#: p2�j Town#: i/7 N Range#: l W Town of:SW;S 5 o <br /> g. r <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> Tax ID#(1-5 digit number;found on tax statement): • <br /> Proposed Use of Structure/Addition. (10/74ie ,6..( ,?u 5:%t c-_":., S a) <br /> o <br /> Anticipated Start Date: !Lj/ S�� - <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) � <br /> Building Contractor: g6-1-fal u h Sewer Installer: At .-3 U <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 4J <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: us <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed front them prior to t 0 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z tl <br /> home additions,and bunkhouses.** x <br /> x Fee Rec: 02(A))A <br /> 7 Check#: 24 021-1 <br /> o <br /> rn <br /> Date of staff site visit: l/d I2'-'01453-0 Initials of site visit staff: ,14---__ ri <br /> 4.re <br /> APPROVED BY LAND SERVICES OFFICIAL: ATE: `0-ad -?-0 45 < _ji <br /> r: <br /> rtr- <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF tut <br /> � tW �.-I <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ' <br /> Transcendent: - Page 1 of 4 'hv c° res <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 6/2020 iK <br /> c) <br />