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LAND USE PERMIT APPLICATION — Burnett County, WI a 2 <br /> b <br /> Applicant Complete All Sections Below This Line • o <br /> Permit Types and Fees:(Please,check appropriate boxes) a. 1 <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 'W <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 1 O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ' <br /> - <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 Cl <br /> Filling/Grading $150 Boathouse $500r- <br /> PID ik4 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year 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. • l+�- <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. 9 <br /> Property Owner's Name: M rK 4 Melanie- leo r Le z <br /> IIII <br /> Property Owner's Mailing Address: g LJ 1 9 3 0 fru I R(i V146 k'J 11, ,' <br /> L City State Zip <br /> Property Site Address: 1��5 Owl Ldke EBF i tYtkie ,1 (ti .452/A"i3 ,' n <br /> Contact's Telephone Number: r)/c" 5Ol - 0;01,1 ("-i i7/6 — -t Si 7 o F • <br /> Contact's Email: (,)01(- 4e, Chi J i yl r ��v�'� t ' i (00 1 o <br /> Legal Description of Property: 1/0t I £5M V a -N,D O ` 6o v i_-mi- 3) <br /> D ' o ,. <br /> Section#: 0 Town#:O3 N Range#: 16 W Town of: ISA /0/) e lu I _- =_ <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* p <br /> Tax ID#(1-5 digit number; found on tax statement): 3 4 i 13 <br /> ' <br /> Proposed Use of Structure/Addition: S40 i" i ( l"n 1((- h Li i i t) ,,f, <br /> Anticipated Start Date: /\)'it (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) T E r x <br /> • o <br /> Building Contractor: N I I; Sewer Installer: I 4 ! <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMIMIENTS/CONDITIONS ONLY _ W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: • <br /> • <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 91 <br /> home additions,and bunkhouses.** m <br /> Noy 6e. ti 4/.. 1�u IAA.qR A4,�/' 740 , (1'' <br /> Fee Rec: <br /> _a(5_,'9 <br /> U Check#: <br /> Date of staff site visit: /Z/f 0/W2e Initials of site visit staff: K z <br /> APPROVED BY LAND SERVICES OFFICIAL: 9 �. ---- DATE: / d/ ^ o r <br /> Uul <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF h T <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT { o <br /> Transcendent: - Page 1 of 4 rr:x 0� a <br /> Laserfische: - Burnett County, WI Land Use Application— Rev 6/2020 m J ii <br /> o <br /> VIa <br /> K <br />