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LAND USE PERMIT APPLICATION— Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 0' c <br /> Permit Types and Fees:(Please,check appropriate boxes) c- r,..1A <br /> . Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 wU '~ <br /> s 0 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Vccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °< <br /> Filling/Grading $150 Boathouse $500 C. <br /> Six Month Cam One Per Year ° <br /> in Unit <br /> p g ( ) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> Cl') ,,1 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> P. <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. n <br /> ` r E. ) <br /> Property Owner's Name: c C k) Vi L ,� FW A oe ° z <br /> s--,(J-1°��, s--,(J-1° P <br /> Property Owner's Mailing Address: fg(j,(p::) Welt et /2� Div� �w7 (�tJi o <br /> �,J City State Zip a_ thP <br /> Property Site Address: - f v <br /> Contact's Telephone Number: to 1 1 is3 9- des'L'4' o y <br /> •Contact's Email: S cure 2 C- )r. O C G vL,.sil l , ( oh— d <br /> Legal Description of Property: <br /> 1..-0.-t- Qs t/l Piaci �l <br /> c N -0 <br /> Section#: `/-3 Town#: TL N Range#: i 7 W Town of: VAi'� = w <br /> ' <br /> S. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p <br /> n <br /> Tax ID#(1-5 digit number; found on tax statement): <br /> ( a q O ' <br /> Proposed Use of Structure/Addition: T'ta�ot-- -g"-C- \ cA <br /> Anticipated Start Date: /0 (3o 1 a0e>a (Home/Cabin;Commercial Business;Bedroom;;Deck;etc.) ,-3 <br /> x <br /> Building Contractor: Sewer Installer: C <br /> d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <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 ./ :13 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes, manufactured z J ci <br /> home additions,and bunkhouses O C + `gr\ 7. <br /> 16000 <br /> :1Fee Rec: <br /> y Check#: ,23114 <br /> Date of staff site visit:/0"---/ . Initials of site visit staff: 1\l _ �--- -�- .N. <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:Gd r—e-P.O C) %1 g 1..p.T <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 6 y_1. <br /> -Li Liu i <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT s7' N <br /> I <br /> Transcendent: - Page 1 of 4 ,pq. L c= 1,,,,1 <br /> .-1,_ __Juuul <br /> Laserfische: Burnett County, WI Land Use Application-Rev 6/2020 <br /> m <br /> 0 <br /> K <br />