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r <br /> •• LAND USE PERMIT APPLICATION—Burnett County, WI b <br /> cr N <br /> Applicant Complete All Sections Below This Line 0 <br /> o ~ <br /> Permit Types and Fees:(Please,check appropriate boxes) d0.1 <br /> Dwelling/Principal Structure $300 ,Addition/Alteration to Dwelling/Principal Structure $200 g <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 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ., <br /> XDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 < k) V <br /> Filling/Grading $150 Boathouse $500, o N ` <br /> Six Month Camping Unit(One Per Year) $100 _ Permit Extension(1 Year Extension-Allowed Once) $100 <br /> vn . <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. o <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: (0 f And J4 ra f h M /el � <br /> / G / c <br /> Property Owner's Mailing Address: 5't'' (/'ee>7 4 rla r' 4/1e, Waa4��'ny AI 5-pir ° �' <br /> / / City State Zip <br /> Property Site Address: h7S 9 fe ytn L'r/of �'t� /- v9h 4',j, WI SWJ€ a' <br /> Contact's Telephone Number: asl— `/7,-y 77 c c <br /> Contact's Email: 1.sc knia/f 3i9/ 69,074,/ Gly dPI I , <br /> Legal Description of Property: <br /> J 0 0o <br /> Section#: Town#: N Range#: W Town of: t�7/lt/a P i .. <br /> *Attach additional page i needed or lengthy description OR attach a copyofthe deed OR attach taxsystem property page.** 0' <br /> P S .r f S Y P P tYP 8 d <br /> Tax ID#(1-5 digit number;found on tax statement): /2 P D V,� . <br /> Proposed Use of Structure/Addition: v&kr t^ _peg ii/!J 9' `4 <br /> H H <br /> Anticipated Start Date: 194/z e 2) (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) i <br /> G <br /> Building Contractor: Sewer Installer: <br /> H <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY c \ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkhouses.** x' <br /> — fe,r 6eV, 30-6.77 *i r5 c-f$e> 71"k ZS-70 <br /> al/o'/f 1r ex/ow-is/oil/ <br /> o M eekl a -bsc itS g Fee Rec: A2,,5? <br /> tn <br /> Check#: 3 <br /> ri <br /> Date of staff site visit:6 (1U / I Initials o site visit staff: v---)L— ri <br /> 0 <br /> - / � b/ /��� < �o� <br /> APPROVED BY LAND SERVICES OFFICIAL: �I DATE: m <br /> m mIfiiii <br /> UPON APPROVAL: APPLICANT �< ST POST COPY OF0. <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z 0 ^' nnn <br /> 00 <br /> Transcendent: Page 1 of 4 P w r.." �' <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 12/2020 _ ' <br /> a 0 Effil <br />