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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> s <br /> a "0 <br /> Applicant Complete All Sections Below This Line a' <br /> Permit Types and Fees:(Please,check appropriate boxes) ;1; � 9u, <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 v <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,. <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 r <br /> 0 <br /> Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n �3 I.Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c° <br /> V <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> cn <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> 74. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory <br /> ''structures,such as:pergolas,landscaping,—etc. 1 -a 1r <br /> rc�e 11�, t� 1�0�2��5 EVC�C cLb �. /lr U5 I 0 la z <br /> PropertyOwner's Name: 1 1 I 16 <br /> 1-- o C'l, <br /> Property Owner's Mailing Address:eg g3 9 UOtr1,,l,,ci OYl 1-G�- Rt onbuu Li ()AI -r5' LJC'3C) <br /> `` __ Q r City State Zip z 73 <br /> Property Site Address:Z2 Sq-76.1-1,r)-6bn LO-KQ. 'Xf Thank)i,ld'i,i, C-l)1. 5' '7. <br /> C) K <br /> Contact's Telephone Number: 7(4 ,( 5 0 3 9 0 o <br /> �' I � e P <br /> Contact's Email: �-1tt;��� p��QE.S a�� <br /> .- 4, <br /> � .� ')Cl 1 � � d <br /> Legal Description of Property: Pc ) 6 E S E <br /> f c <br /> Section#: ) 1 Town#: 1-j U N Range#: I is W Town of: c)GLk 1-Ci.nCis . <br /> *Attach additional page i needed or lengthy description OR attach a copyofthe deed OR attach tax system property page.* �` <br /> Pg .f .f g Y P Y P P YPo p <br /> Tax ID#(1-5 digit number; found on tax statement): ,) ,�j 19 D <br /> Proposed Use of Structure/Addition: l'o)'e 5ke v <br /> Anticipated Start Date: £////;:q/ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) k <br /> d <br /> Building Contractor: Sewer Installer: <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 <br /> z I <br /> home additions,andn�dbunkhousees.** a <br /> 0 Di __ l <br /> T� sed -f - u1ticin h0.b. 4- fivr <br /> Fee Rec: t56 Cm <br /> cA Check#: 3i-e3 <br /> 5 <br /> Date of staff site visit:, /10 41 I Initials of site visit staff: 0.VJ•r > �,.�— <br /> APPROVED BY LAND SERVICES OFFICIAL f� '�+,I DATE: 1/1/� ' 4€ .- <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> AT <br /> a <br /> N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT "' "� <br /> E.:J N <br /> D U <br /> Transcendent: - Page 1 of 4 .� N m U) <br /> Burnett County, WI Land Use Application—Rev 12/2020 �' <br /> Laserfische: - _ <br /> J <br />