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• <br /> LAND USE PERMIT APPLICATION—Burnett County, WI a ! U <br /> - b <br /> -+ <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and Fees:(Please,check appropriate boxes) 1 * <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 I p <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 �! <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ' <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 Z U/ (5: <br /> i0 I� <br /> Driveways/&Campground Structures $125 WI State Statute 59.69211y)Structures $350 1 .. 9+ <br /> Filling/Grading $150 Boathouse $500 , tr\+ "1 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 - <br /> n <br /> *NOTE:After-the-fact permits(permit squired 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. I o <br /> 0 <br /> Property Owner's Name: Lot t OAS( z <br /> Property Owner's Mailing Address: 23221 SNE- C DA Le w'4 tiyA) IIN 553/-1. o1 1 <br /> �" o"N LANE, <br /> ,, <br /> R. <br /> Property Site Address: (PO( (-4AYONE, ecAia O4_ _ <br /> city State Zip <br /> 1` L3ct.0eV W 519cn <br /> Contact's Telephone Number: tp (2 - ZI -453 1 o <br /> Contact's Email: o it Any b°Y�°Y Mac . GOA � <br /> J C <br /> Legal Description of Property: LtiTZ f t.ta .x ��60s v•3...^ , <br /> N <br /> o <br /> Section#: 0.3 Town#:7 / N Range#: !Q((o W Town of: O04KL.4N1 0- <br /> n <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system properly page.* <br /> P <br /> Tax ID#(1-5 digit number.found on tax statement): 3 3 6 81 ,, <br /> Proposed Use of Structure/Addition: GAIL/46e- S704466 I� `" <br /> Anticipated Start Date: /ei(I/21 efome'Cahin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: D4reALY(Se-ffa.t 0/44/ 4 SA `ewer Installer: A/4 <br /> ! <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: J. <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to j QQ <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z ..-.t.home additions,and bunkhouses.** <br /> (►'1 teA- 0.1( C, <br /> p Nod 6( hvt or <br /> j 1")4 ,S fc,12g-I- 1 L % e'lil erVi'ou-S 5M(! CC 4, <br /> re Ceti v' I /lee() a I ac 0.4- i;Ae o-c 21 Fee Rec: <br /> m <br /> (v:ou St,,r‘CRs AD Mc4ke S <e t ,46{;J WI <br /> 44HDA 1s /t pl Check#: <br /> Date of staff site visit: 9/9 0-I Initials i f site visit st. :1-"12----- r <br /> I- i - �j�� 1131d) '' <br /> APPROVED BY LAND SERVICES OFFICIAL: �� � , 74 �jj DATE: � n r <br /> UPON APPROVAL: APPLICA iii UST POST COPY OF ra <br /> a m iniii co <br /> Z.3 <br /> -0 03 rn CS? <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT . cEiji <br /> a o <br /> Transcendent: - Page 1 of 4 w c <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 12/2020 <br /> u <br />