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• <br /> LAND USE PERMIT APPLICATION -Burnett County, WI cr g <br /> _ 7.7. b <br /> Applicant Complete All Sections Below This Line ' c N <br /> Permit Types and Fees:(Please,check appropriate boxes); d CD <br /> ° b <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 v 60 <br /> ommercial/Industrial Structure $300 Addition/Alteration toCommercial/Industrial Structure $200 <br /> p <br /> ccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> g • V <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o I <br /> Filling/Grading $150 Boathouse $500 -- <br /> Permit Extension(1 Year Extension-Allowed Once) $100 ' R <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. . l)\ <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ' o <br /> �TPropeOwner's Name: Ta17 t� T? e o <br /> o.e. <br /> Property Owner's Mailing dress: 7 17- Lciry ' nCity State Zip - - < <br /> cd____Wegr . <br /> Property Site Address: ( 9).J77fE 8.T <br /> Contact's Telephone Number: r0 - f ^,- 5/ d <br /> Contact's Email: 6 r . r- Air r -1--'&.i . e_07-77 z <br /> Legal Description of Prope !. • ' or. _iI i,A . 1'" ?' Al.oce d 7 <br /> Section#: Town#: N Range#: W Town of: , I bAry R. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system// property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): ft / .4 o <br /> Proposed Use of Structure/Addition; qt V' - <br /> Anticipated Start Date: -- i i P' / (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) `3 <br /> Building Contractors j&.).5 X'f S 1_1Z Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> z <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.** <br /> $1\1,4-40, <br /> iTh 1- l Ste-,4&,,4 1(tahr -bn I ., Fee Rec: C,51)- <br /> y Check#: % <br /> ),,/t <br /> o <br /> Date of staff site visit: 5//7C/2-� Initials of ite visi st f: <br /> /// z . <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE/f. u2'/� Q <br /> 511 <br /> UPON APPROVAL: APPLICANT /UST POST COPY OF a <br /> Inas ?->.< 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> -,1 <br /> H G� <br /> Do <br /> Page l of 5 <br /> Burnett County, WI Land Use Application—Rev 12/2021 < m-1 1.^.3v _ <br />