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LAND USE PERMIT APPLICATION - Burnett County, WI <br /> Applicant Complete All Sections Below This Line 0 <br /> Permit Types and Fees:(Please,check appropriate boxes) ,�- a' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 a' 6 <br /> X <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 —•,..1i <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 9 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0 i <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 I <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 QO` i. <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 ...., i <br /> *NOTE:After-the-fact permits(permit aquired 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. , <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: .,`r y . /-4(_c 3 '1�S I <br /> pMailing 2 s 7 :L � )'edo t.) ter- �Q' <br /> Property Owner's Address: t <br /> Cit State Zip i <br /> / hur was y E <br /> Property Site Address: ` % z Y r `c' 3 <br /> Contact's Telephone Number: 7�.3".Z2 ! ?� � ' z C <br /> Contact's Email: I/ a(/,' ,5ary civil, e d,c 4' ,u--, a <br /> Legal Description of Property: Pile rids Gv - <br /> G 4/00 o do <br /> Section#: )O Town N Range#: ILI 4' W Town of: ef) 4.4. 8. <br /> *Attach additional page i needed for lengthy description OR attach a copy ofthe deed OR attach tae system property page.* <br /> * zz <br /> 5. <br /> qo <br /> P S .f 8 P r1 P P P P8 <br /> Tax ID#(1-5 digit number;found on tax statement): ! - <br /> Proposed Use of Structure/Ady;ition: 6c/41C/ ixc�/a=� f5.- ,�t rcer-1S Com) ase `" <br /> Anticipated Start Date: Fs/tSI�OZI (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) .I5 3 �'c <br /> Building Contractor: SOC U/b4 ' Linde Sewer Installer: e,k/ns �� <br /> i <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 r ' �1 <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z l <br /> home additions,and bun houses.** i 7 -� <br /> (he e4- a I� SetbaLYlS tell/�velt��anot- , exce,ej beCIPO '' 4w 13491 <br /> a� Q 5 ,5 , - <br /> unleSS`)(le w ` it - <br /> Fee Rec:ca�.�`/c <br /> ( Check#:3 <br /> Date of staff site visit: 7/21/�' Initials of site visit sta • , ' <br /> / A' a <br /> APPROVED BY LAND SERVICES OFFICIAL: W /Z' / DATE: 713O/ 2' '===.41:2) <br /> v, <br /> UPON APPROVAL: APPLICAN MUST POST COPY OF - Q Guy <br /> CD 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 4.< s <br /> w nC <br /> Transcendent: - Page 1 of 4 i? e <br /> Burnett County, WI Land Use Application—Rev 12/2020 1 ., N C4 <br /> Laserfische: - rd ^ <br /> a <br /> i J <br />