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LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line 5' <br /> CD I <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 w <br /> CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 1 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> f <br /> Accessory Structure(Commercial/Industrial) $200_ Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 , t <br /> .,—..G7 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 ,Boathouse $500 -- <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 `r <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. a <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. + <br /> Property Owner's Name: 6—•1 I W ' ��'� z <br /> L6.- <br /> PE) /n-�__,, �1.v p <br /> Property Owner's Mailing Address: 3 d -- .tfL Y - Y&rf , 0i6 0 ~ <br /> 9 L <br /> p/ City State Zi <br /> Property Site Address:306 a Ki..(,$fl A 10,215 w .52/1n3 3 n <br /> Contact's Telephone Number: (p l f`v 70 "100 `C �' < o <br /> w C <br /> O. <br /> Contact's Email: D. fo1 > r ® [, . ( ( "— d <br /> Legal Description of Property: R-11 -C.G. ` /0.-V-- $'ick- <br /> Section#: /CI Town#: 1-10 N Range#: !it W Town of: S coi'/ . °G <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o <br /> Tax ID#(1-5 digit number; found on tax statement): I (6(9' I I P 1+ <br /> Proposed Use of Structure/Addition: biNkivQd"0--- Ye*w'`� "' <br /> Anticipated Start Date: EX, —(,s-- -- )_.0 y( Home/C4Commerci 1 Business;Bedroom;Deck;etc.) . x <br /> e <br /> Building Contractor: -n Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: t;- --. <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 <br /> home additions, and bunkhouses.*1i ,O 5 L-i 7P-)-0-3 30 5+;`i cfp I�/ <br /> J <br /> Alt ler civic"' �t o✓� V (/�J' <br /> a Shop s�ze, reA�cec 4-o loci-i- G:r, <br /> P <br /> i Fee Rec: loo a' <br /> /74 <br /> I r� 1 v <br /> Check#: 9 <br /> Date of staff site visit:6`'4 1 1 2l Initials r f site visit . of : L- z r <br /> _ / - / d __S_,":=1 <br /> APPROVED BY LAND SERVICES OFFICIAL: A,,,,/_41,4DATE:6//5/P < ff <br /> UPON APPROVAL: APPLICANT UST POST COPY OF 1 <br /> ff <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z $ a <br /> Transcendent: - Page 1 of 4 :II If <br /> fi <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 < a <br /> d <br /> N <br /> ,-7 <br /> 3a <br />