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s ^o .. <br /> LAND USE PERMIT APPLICATION-Burnett County, WI 'C <br /> Applicant Complete All Sections Below This Line W ivc. <br /> Permit Types and Fees:(Please,check appropriate boxes) -.c. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200W <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 v �— <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 i 2 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ap y <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk XBunkhouse $250 N <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 e p <br /> Filling/Grading $150 Boathouse $500 r `J <br /> 1—� <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 -1 <br /> E. <br /> *NOTE After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. _ e <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. 3 Z <br /> *Items not listed above wit be treated as accessory structures,such as:pergolas,landscaping,etc. 't <br /> o = <br /> Property Owner's Name: '/r-�,� !�lJc� � z <br /> Property Owner's Mailing Address: 7Gr',3 /2/5 ,i -2<i7 ,? 4 1 607 a �. <br /> / City State p z <br /> Property Site Address: Tic 1-7 7r/.f'A o7 4 v.e OG'c' `�*`Y �J� ti 4' 1 = 4 <br /> Contact's Telephone Number: ('61 —pZ, .— cg/.2_ <br /> Contact's Email: (h o 4/tt'I.J,4/ .3 O N)9j4ivl!l; 4:",-, <br /> 0 <br /> Legal Description of Property: <br /> Section#: CI' Town#: Yo N Range#: /6 W Town of: 00. -\ark <br /> 5 <br /> m <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page.* t7 <br /> Tax ID#(1-5 digit number,found on tax statement): 3 3 iT/ 99 <br /> Proposed Use of Structure/Ad�ion: Vev if I.5:', !`' -3 -3 <br /> Anticipated Start Date: L "�7 i (Notre/Cabin:Commercial Business:Bedroom:Deck:etc.) 3 < x <br /> iti <br /> Building Contractor: 4).\v3 I\a C Sewer Installer: <br /> 4Iv <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 <br /> Ii41-14.... <br /> home additions,and burikhou *: <br /> �z f1 <br /> @Meek a 5 -i'10`' <br /> 1 <br /> s <br /> Fee Rec: Io'Z�� <br /> I = Check#: 1 O 27 <br /> Date of staff site visit: 7(71 Initials o site <br /> 71,, L mz <br /> r <br /> APPROVED BY LAND SERVICES OFFICIAL: / / DATE:? <br /> rt/`?1 < <br /> m <br /> UPON APPROVAL: APPLICAN ', UST POST COPY OF <br /> r BOJ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° <br /> Transcendent: - Page 1 of 4 �° a �— <br /> N <br /> Laserfische: Burnett County,WI Land Use Application—Rev 12/2020 ` <g i-- C <br /> M � <br /> a (1) n cr, <br /> 4 C C ^1 t. <br /> 3' :•a <br /> m <br />