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LAND USE PERMIT APPLICATION — Burnett County, WI i <br /> N <br /> Applicant Complete All Sections Below This Line 5' e <br /> n 1 <br /> Permit Types and Fees:(Please,check appropriate boxes) - ` O <br /> Dwelling/Principal Structure $300 V Addition/Alteration to Dwelling/Principal Structure $200 ItI <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 ,' O <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 r- <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. 14. III <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: 1410/'� cw'Gns O h .- r‘ <br /> Property Owner's Mailing Address: RQ DC. 3 ` Oo?/5" Edit/A_ #44,4 ✓$yy ° , <br /> u ,/ / A i City State Zip r <br /> Property Site Address: /a'/07 iedrtr of f /er / ' , ,+ :(,v�I, 4 �3, A 0- <br /> Contact's Telephone Number: 6/2 _ 730, 4/ '3 9 Z E <br /> Contact's Email: 0 cWAALC0/( ./414 .5J 75;a 1 e- n. <br /> Legal Description of Property: 1077 1501 ✓1 , 1 qat( yr 1-07- 4) N <br /> Section#:a°v Town#: 37 N Range#:/rto W Town of: Cade Lake— 3 °° <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> Tax ID#(1-5 digit number; found on tax statement): g.:3�ent): 7 � �' <br /> Proposed Use of Structure/Addition: 6 a � 55(vee' yOD rC L Co i/i -Ce. 'd z <br /> Anticipated Start Date: //ie ao (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o <br /> Building Contractor: .6 „j_ Y Sewer Installer: /1///- <br /> I a <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 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured Z 1 <br /> home additions,and bunkhouses.** <br /> f /U (o cod cAct 1'14 i'r4 s ,e-cl m ti s tt971L- Al AL <br /> by 2/i/ o&'. <br /> /'Via sur - 17, c,OIA-Ael- (,1 dG /Nq e-c-719," see- /' ' y GILZ)-42 <br /> x Fee Rec: <br /> y e (4 ne / G peri /- s <br /> / IA,.... *Ike.v Al 4 Check#:38'(n( <br /> rz <br /> Date of staff site visit: I Z(,4('.ze ZO Initials of site visit staff: t /l ' <br /> r <br /> APPROVED BY LAND SERVICES OFFICIAL: fmmo& DATE: /27/7/40 FeMI <br /> " a C.. <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF CD 3 a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT r o <br /> Transcendent: - Page 1 of 4 g f, <br /> Laserfische: - Burnett County, WI Land Use Application - Rev 6/2020 m <br /> G <br /> w <br /> 4 <br />