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• LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> z. <br /> VD t4 <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) a� . <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d 90 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `,�o <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 1 . c9 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 < P p. <br /> Filling/Grading $150 Boathouse $500 C- <br /> o <br /> Six Month Camping Unit(One Per Year) _$100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> c <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. w <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. -1 ,11.1 �f L/�QLI. s. , `C+ v✓eJ ° z , <br /> Property Owner's MailingAddress::.•!! d1 7J o� 7 6P, .) i's 0464 ( 37413 o I. <br /> P Yo <br /> �A ^^A City State Zip �J <br /> Property Site Address: w.Jls Ai e/"• QC / "VEL t�i N Add✓ E• <br /> IP/ <br /> Contact's Telephone Number: 7/.5''' TIP '-''7 '' o y Fp <br /> a <br /> Contact's Email: ( f.):9j (LA.1/ g Y,../1 . 0 6M.... <br /> Legal Description of Property:V O lr'• (� p 7 ✓� /'#,, 34- T lit AR.. /l'f' 0 V <br /> N -o <br /> Section#: Town#: N Range#: W Town of: ccCQ <br /> o. °c <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> Tax ID#(1-5 digit number;found on tax statement): T' <br /> Proposed Use of Structure/Addition: eatede,v Meuse_ £�O✓ <br /> Anticipated Start Date: /0 `/At (Home/Cabin;Com/nercial BusinesY,Bedroom;Deck;etc.) 52 . o k <br /> Old If/6i ✓1/ 7cifN/A 'S' Sewer Installer: 9—,Building Contractor: <br /> AREA BELOW THIS LINE FOR LAND SERVICE 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 •v <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** <br /> Vlie&t-A co Sc-}-6 <br /> ot ,4,/ k.ongo sit-!gji‘.-)-i`c) <br /> z Fee Rec:r, <br /> 0 <br /> Check#: 11 0 <br /> ril <br /> Date of staff site visit: 9IP} / I Initials o site visit`, f• 'rI <br /> �. / s nAPPROVED BY LAND SERVICES OFFICIAL: *-1.'Z �1 <br /> .. pd.> Oil <br /> UPON APPROVAL: APPLICA MUST POST COPY OF V <br /> m <br /> CS? <br /> fV (� <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT , �Y� <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 �' <br /> v <br /> y <br /> 'O <br />