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LAND USE PERMIT APPLICATION—Burnett County,WI a <br /> Applicant Complete All Sections Below This Line grc <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> A <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `�t--- <br /> Accessory 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 Z <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 c it <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 U <br /> • <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. •i 'il ' <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. Al 1' • <br /> * Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ,;' <br /> K ��1 <br /> Property Owner's Name: 0/ Lr #i-1270 (, ��rr� / , <br /> Property Owner's Mailing Address: /92,, Aide. O""jf CT' A,de.5 AA MN 3'5//2_ c 11:4• <br /> j City State Zip .o ( p, <br /> Property Site Address: �r��` / ("<,',Air-, s? t I JT �C.z�i f .✓�', 1.'�/ .s ,7�v� 1,V�' <br /> Contact's Telephone Number: 6 Si- 2. 0 el-C+' �425o t <br /> • c <br /> �� a <br /> Contact's Email: 1 d d.• /4, .9>/''f'O�j e, was,-,,--7, , c a, d <br /> ,� j fit fCD <br /> Legal Description of Property: I a 74'1 C5,4 ' vo/ :1. A�� �� 3✓<-y'��j ?' i�"N ro <br /> Section#: 9 Town#: 40 N Range#: /4 W Town of: 3'•!`t] 0 00 <br /> *Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system property page.* <br /> U. <br /> rA <br /> Tax ID#(1-5 digit number;found on tax statement): t- 2 3 514-2 <br /> Proposed Use of Structure/Addition: 6 t-r € "' <br /> > o H <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 3 <br /> CI <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY D <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 3I <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 /> home additions,and bunkhouses.** %c, <br /> 4‘6..\--e•..\\*\ CIV\ <br /> Fee Rec: <br /> Check#: 3 <br /> J <br /> Date of staff site visit/ itials of site visit staff: .\j\ 3 <br /> ( 7 <br /> CA <br /> CZ <br /> q <br /> APPROVED BY LAND SERVICES OFFICIAL: c\)\)46.'Q.,�DATE/0� / �� P4 � �' <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF y w -cz ,��7 <br /> yup <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CD c CS) <br /> Transcendent: - Page 1 of 4 g •Iffl <br /> CI N = _r <br /> Laserfische: Burnett County,WI Land Use Application—Rev 6/2020 ma r3 <br /> Cl �'s< IV <br /> co <br /> 3 0 <br /> mgill <br /> L <br />