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LAND USE PERMIT APPLICATION — Burnett County. W1 <br /> Dwelling/Principal Structure 1$300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $3100 E.lAddition/Alteration to Commercial/industrial Structure $200 0 <br /> jd <br /> 50 <br /> I &Le�,�;utv SUUL[Ult 1Gd[dkV.Shed.eU611 11 iAdditiviiiAltefacivii W AW:�,bOIV SO ULWIC SID <br /> 7,- f r -j mr-, n- <br /> Driveways/&Campground Structures $125 jWI State Statute 59.692(lv)Structures $350 <br /> Filling/Grading ­4$1501 lBoathouse $500 <br /> Soto- . % -e �- prcrrmt (.1 Year Extension-Allowed Once; :�ILPJ <br /> P-inccz,, tang Wone or rooT mount,--.; i u <br /> =fter he­aCT PC—T P.er-r t acqif-nd Rftc-r co-strA72o-has;_-eg'_n',may coq p to t`fr tt.!:narmT4 <br /> ti <br /> -,ding <br /> Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name:__.__ --�,e <br /> cA. <br /> 0 <br /> P-mn,-.7tY awai z_ov 1 ,n,.tVC t_,f6Ai*v M 7 <br /> Property Site Address: < <br /> Contact's Telephone Number_ <br /> **-kf StdffbAS a qUeStiOD ai.K)Ut t�i,S A-0pi'lGal:i0ti,YOU Will, Ot wl'ttaf,tetd V:.,x eina"", Make stile yow,ejroA'1.,,acklmss is <br /> 10 <br /> and yzur t;a& plow-,_kT vr0l accept ernai'tss fiam the fa�]Owirkg add;,-S3: v 9. ai <br /> Legal Description ol'Property 1� �7 <br /> 0 <br /> CPrtion __: <br /> Town of:#-__a� Town W N Range <br /> a e-op 0 the dee <br /> d�)R a ,j, <br /> *At&wh additional page;rneededfor lengthy dacription OR attach coat' f t-ch prZVe_jy prage. <br /> -4 <br /> ax #(I-j 1&t num'64rq found On tax atattrntrW Y9 V)q <br /> 5 <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: J( omean;Commercial Bedroom;Dee ;etc) <br /> _U-1,-gS _ H lCbi C il B Bd k .4 <br /> Sewel_-IlAdilcf. <br /> 4wi­140A, LIS iE14 i6JEtAj_w: <br /> rneeT 4(-L SC-TS460 <br /> O <br /> AJO-F -r6 Se- u,56C> <br /> Check#: 1034 <br /> in <br /> q13 <br /> , Cn <br /> 257 V CD >_ <br /> APPROVED LAND SERVICES <br /> BY LAN SEVICES OFFICIAL:': DAT q j-j j:Z o <br /> ,k �k E: Z.3 <br /> (D <br /> n IV <br /> m __7 1_w' 7 z: _w..... r_ i_. _;;_1 <br /> 9 1 ir,a ff I 1W 4* a-a-we a 9 W LU 9- VM .09 4& t%d 0 1 W 2 5 1.'% K W-2 ff.�% 1 2 2 XW- W 6 RIM <br /> 0 0 <br /> CD C: <br /> IN <br /> CJI <br /> CD <br /> Pagel of <br /> Burnett County,W1 Land Use Application—Rev 11/2024 <br />