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LAND USE PERMIT APPLICATION-Burnett County, WI <br /> b <br /> Applicant Complete All Sections Below This Line i, ll <br /> Permit Types and Fees:(Please,check appropriate boxes) _ 1 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 '1 <br /> Commercial/Industrial Structure $3Addition/Alteration to Commercial/Industrial Structure $200 <br /> ( <br /> X Accessory Structure(Garage,Shed,etc SD,$2StT Addition/Alteration to Accessory Structure $150 ,`._.7: <br /> r <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 I f ,' I <br /> Six Month Camping Unit(One Per Year) $100_ Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE.After-the-factpermitss <br /> (permit aquired after construction has begun)may cost up to three times the normal e. r�^ <br /> *Communication Towers: igns require a.r erent app ication orm;see correspon.in.app . Y '7 <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> o <br /> Property Owner's Name: .re-I 4- and Kell U Sc,hu_142_ ,,;� <br /> Property Owners Mailing Address: J -172 193rd Leine Nu-) EA K River Al 55o c- �� <br /> City State Zip �� <br /> Property Site Address: aLI7554 Sand Lake. har s "i'a; I WP,b.•ter- lkl.- E <br /> s4843 : < <br /> (p 51 -a - 112 < <br /> Contacts Telephone Number: �g It I , <br /> n <br /> Contact's Email: I'Yl n les`V e.c: re}S l_CCM Plik <br /> 0 <br /> E. <br /> Legal Description of Property: Lai- LA S arid. LR,te- Shoves 1 <br /> ti <br /> Section#: 0q Town#: 34 N Range#: /5 W Town of: C O ue 4-I-� - "-- <br /> ` <br /> °% <br /> *Attach additional page if needed for lengthy description OR attach a copy hf the deed OR attach lax system property page.* <br /> Tax ID#(I-5 digit number:found on tax statement): /0a5 7_ <br /> Proposed Use of Structure/Addition: S4avaie. <br /> ' <br /> LAntici <br /> Anticipated Start Date: I a- We-Z v (tlnme-Cabin:Commercial Bedroom:Deck:etc.) i ^ <br /> Building Contractor: NIta- Sewer Installer: N In 1 <br /> 1 — <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY i ;'- <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to f c <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z r..., \+ <br /> home additions,and bunkhouses.** AL1 r x CeI <br /> ask ael-e4^- <br /> LJ Ea 5 ! �A.ed - <br /> 144 Q A.).71- iv be- Us uQ �a6/, �� i <br /> Boa) <br /> Fee Rec. <br /> ''� s Check#:33j, <br /> Date of staff site visit: ��7 �2-/ Initials of site visit staff: / / i 4 <br /> p. v �oJ <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 4o 00 Zi < r <br /> Ilifil <br /> UPON APPROVAL: APP ICANT MUST POST COPY OF = it <br /> R.3co 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 1 s o co <br /> of III <br /> m rsa <br /> Transcendent: Page 1 of 4 x 4 CZI <br /> Laserfische: - Burnett County, WI Land Use Application— Rev 6/2020 < g <br /> 7 <br />