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LAND USE PERMIT APPLICATION - Burnett County, WI <br /> y N <br /> Applicant Complete All Sections Below This Line c ;' <br /> Permit Types and Fees:(Please,check appropriate boxes) 1 = 1..7- <br /> X Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 1 CA 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 O <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ! < r <br /> Filling/Grading $150 Boathouse $500 1 <br /> r <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 1 A <br /> u 3'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. 1 ,5 <br /> *items • <br /> not listed above will be treated os accessory structures,such as:pergolas,Landscaping,etc. R <br /> 3 <br /> Property Owner's Name: pt,.<,i l C,c13 12__ebt' cfs_ SQL-' z <br /> Property Owner's Mailing Address: /,,g ye ) ,Skyt./A4C tp, U J5Q1CL T <br /> City State Zip $ <br /> Property Site Address: _ n <br /> Contact's Telephone Number: 65 / "33(p ad 5a ° <br /> r (( � c. <br /> f Contact's Email: pb-ese -26 f'€ h cf-re 1 . c sn r t T� Y <br /> Legal Description of Property: 4o1— . C5M S�j (h ✓p I, 13 P( �!!''' t- <br /> Section#: Town#: N Range#: W Town of: �)5te '° <br /> 'Attach additionlpage ifneeded or lengthy description OR attach a copyofthe deed OR attach tax system property page.* m <br /> I S P P lx PaR <br /> Tax ID#(1-5 digit number;found on tax statement): 1 S C1 I 1 , <br /> Proposed Use of Structure/Addi ion: C_p_)1:7( R J <br /> Anticipated Start Date: _! (Home.C'abin;Commercial Business:Bedroom:Deck:etc., F. 5 <br /> BuildingContractor: +\C- / T <br /> �Q�� Jr Sewer Installer: M 4� � <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLV (11 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> *"t he upplicuut needs to c(intact their I lit ln!pet tu, to eieteruttvle i/it permit is neecleti/rm,t Utrm OW/ tr <br /> I'\F construction taking place/or any dwellings, dwelling additions, maim] lured homes. manufactured Z <br /> home additions,and her nl:hnuves."" , X <br /> Al ek- at Sefbc+d <br /> • eK abejr,,,,,n5 <br /> ,_. 1 <br /> a) )--08 <br /> i Fee Rec: l <br /> FA <br /> Check#: 75� <br /> / m <br /> Date of staff site visit/3 ?-1 Initials o .ite visit taff: r/ r- <br /> CD <br /> APPROVED B1 LAND SERVICES OFFICIAL: ,�� % DATE: r/(bl c7'UPON APPROVAL: APPLICA .ev f UST POST COPY OF . t(� <br /> HT = <br /> (.'' [fa <br /> PERMIT APPLICATION IN PLAIN SIG to <br /> 0 <br /> Transcendent: - Page 1 of 4 Q' <br /> Laserfische: IND <br /> Burnett County, WI Land Use Application —Rev 12/2020 <br /> ' <br /> a <br />