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LAND USE PERMIT APPLICATION–Burnett County, WI <br /> b <br /> Applicant Complete All Sections Below This Line a c <br /> Permit Types and Fees:(Please,check appropriate boxes) n. <br /> Dwelling/Principal Structure _$300 Addition/Alteration to Dwelling/Principal Structure $200 r <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure _$200 "�00 <br /> XAccessory 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 /> C) ; <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 O 1. <br /> Filling/Grading $150 Boathouse _$500 r M <br /> Six Month Camping Unit(One Per Year) -$100 _ Permit Extension(l Year Extension-Allowed Once) $100 2. <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. = <br /> 74. IL <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. CD <br /> �/ <br /> ^ (�1 <br /> K�,,'i w <br /> Property Owner's Name: b H. EI' 4 4 Qrl/1 o l <br /> PO <br /> Property Owner's Mailing Address: r b X (Q)4 we i - WI 5�3 o r <br /> I cash' a53j lot City 61- i—c✓i tate _ Zip <br /> PropertySite Address: = <br /> (N0� 9. <br /> Contact's Telephone Number: lI Jr -?��" a- (p .— o_ <br /> c. <br /> Contact's Email: �.� .rGrrl i►/ ./:.. ..il <br /> , b,i i. III/ o <br /> n vPo <br /> Legal Description of Property:5 PL NLAD 5'EA) FX NIYI V Ro Pam( 1 EX C1SM V7-3 <br /> q 'i,.' g 00 <br /> Section#: � Town#: J 1 N Range#: I(P W Town of:-�� �3� �t✓ ttW}c �. <br /> 0. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* / <br /> N <br /> Tax ID#(1-5 digit number;found on tax statreemee�ntt)):p �3. 1 j <br /> Proposed Use of Structure/Addition: r11ST"'"'""„- 1?..1416crite- 61-0:41 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o h <br /> Building Contractor: Sewer Installer: <br /> 14� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY [t) <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: N <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed front them prior to <br /> ANY construction taking place any dwellings, additions,manufactured homes,manufactured <br /> Z <br /> takingJrf. � ,dwelling f' f <br /> home additions,and bunkhouses.** <br /> —� Ttil'S i$ of IA a -tAe--4e per � <br /> I/ pl* ,4e, pplyc <br /> 14 titit, gIle we-a? per GUP-- /$ -//, ig, oeo ?Q/ <br /> j-1,, 4k low CUP appyr ✓e C , D0 <br /> Fee Rec: ' <br /> Check#: OW <br /> Date of staff site visit: 1 1 1 9 woo Initials of site visit staff: /7, -- rnz <br /> v <br /> � rn <br /> �f <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: /I�' ee"" 7, <br /> n <br /> UPON APPROVAL: AP ICANT MUST POST COPY OF a z �1 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT K -g o <br /> tr. <br /> N IM <br /> Transcendent: - Page 1 of 4 Fr m 2 ' <br /> Laserfische: Burnett County,WI Land Use Application—Rev 6/2020 N <br /> 3 <br /> 7 <br /> ar M <br />