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• <br /> • LAND USE PERMIT APPLICATION — Burnett County, WI cr t.... <br /> oAPPIicant Complete All Sections Below This Line c <br /> , <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 O <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 E <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 -, <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> *.c.) <br /> k <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 t-0 `' 1 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 O 4 <br /> ,,, i <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. a <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. . r <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. i <br /> Property Owner's Name: C(r‘ s t 6 h W Cj't wa z <br /> Property Owner's Mailing Address: I\Zai - ii-m 4\ LOkir, N ` c)ookoU(71 (Y) L) Q <br /> 3 '\ VC /40 W C t� t IJ�/\(��l � tate Zip • <br /> �,. <br /> PropertySite Address: n — <br /> 21, 9 (' I.1 <br /> Contact's Telephone Number:(„e\2' J Si – i g •o <br /> Contact's Email: C lb l fl I i(wJ0%el CO qj ((1G,1 i ( .om p <br /> Legal Description of Property:I(5-1 q t �G i i 6o v' 9,)„,) Aid 1l to n 1 ll V omo,c,t,Ai i\f <br /> Section#: 1\ Town#: Irl b N Range#: 1 S W Town of: cl(/` (kCSO (\ . 00 <br /> *Attach additional page ifneededfor lengthy description OR attach a copyofthe deed OR attach tax system property page.** °° <br /> P g g Y P P P tJ'P S d <br /> Tax ID#(1-5 digit number;found on tax statement): 1% <br /> t� ` ,J i.(( k cn <br /> 2 <br /> Proposed Use of Structure/Addition: �V'�� ( (I, 1nU t i U ,-.3 ,3 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o k <br /> � cc (� <br /> Building Contractor: N 1'\ Sewer Installer: N ic)t, iz:7 °-i <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 N <br /> ANY construction taking place for any dwellings, dwelling additions, manufactured homes,manufactured z O <br /> home additions,and bunkhouses.** %° <br /> 1-14 its 15 ci iit aFid+^ - 141 e-^ ,c Pe-Ni. ' ''7". 7;, /t5ile. <br /> �' ©4 G 14 p-2D-178', 1� <br /> x Fee Rec: /1:325 - <br /> c2 <br /> OZ5c2 Check#: ?418/ <br /> Date of staff site visit: 1 1 ç/z42 Initials of site visit staff: //' a <br /> ....Io <br /> APPROVED BY LAND SERVICES OFFICIAL: . -— DATE: ///g12-°7-4 $ Q <br /> rri <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF a c-, 5 <br /> fi <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT r ? w <br /> � g o 5 <br /> Transcendent: - Page 1 of 4 xv g N c <br /> Laserfische• - Burnett County, WI Land Use Application—Rev 6/2020 2 `, cm, <br /> oH <br /> i <br /> b <br />