2018/06/26 - LAND USE - LUP - Accessory Structure (Non-Bunkhouse) - LUP-18-204

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LAND USE PERMIT APPLICATION - Burnett County, WI Annlicant Comnlete All Sections Below This Line Property Owner's Mailing Address: w0 Property Site Address: 2% b 0Q-9 5 tla W I City State Zip a C3 UZ`f w z S' Contact's Telephone Number: L2 —'D 50 ~ S.2,:S rl Contact'sEmail: I J 1 ' 1i M0 9JXK-<0 Al 6 1 C, l> M GC / f C OM Legal Description of Property: s i _q J 5yi i—y s -C c7o iU )--1 i_ 610 N e 17 Section #:M ITown #: N Range #: W Town of. y *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. Tax ID # (1-5 digit number; found on tax statement): Proposed Use of Structure/Addition: 5 / OK 4 C L -- Anticipated Start Date: -� 1)iy (Home/Cabin; Commercial Business: Bedroom; Deck; etc.) Building Contractor: 1401re aid/IA Sewer Installer: N01V t - AREA BELOW THIS LINE FOR LAND SERVICES STAFF CONLNIEtiTS/CONDITIONS ONLY THIS PERMIT IS SUBJECT TO ALL/CONDITIONS /L/ISTED BELOW: y Date of staff site visit: 6 - a & " I `t Initials of site visit staff - PERMIT APPROVED BY LAND SERVICES IIX%0owGQ'llom UPON APPROVAL: APPLICANT MUST POST COPY OF SIGNED PERMIT APPLICATION IN PLAIN SIGHT Page 1 of 4 Burnett County, WI Land Use Application — Rev 3/2018 --i car Ir ::� i i Fee Rec:� Permit Types and fees: (Please, check appropriate boxes) Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 Accessory Structure (Garage, Shed, etc.) $150 Addition/Alteration to Accessory Structure $150 Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 Deck/Stairs/Patio/Retaining Wall/Sidewalk Driveways/ & Campground Structures $125 Bunkhouse WI State Statute 59.692(1v) Structures $250 $350 Filling/Grading $150 Boathouse $500 Six Month Camping Unit (One Per Year) $100 Permit Extension (1 Year Extension - Allowed Once) $100 *NOTE: After -the -fact permits (permit aquired after construction has begun) may cost up to three times the normal fee. *Communication Towers & Signs require a different application form; see corresponding application, and fees. *Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. P,-,, t— C),.—, � NT.—.• rv= Q/) L Q ,,. h , � I r- A In V -T C 1: `Crl i ) Property Owner's Mailing Address: w0 Property Site Address: 2% b 0Q-9 5 tla W I City State Zip a C3 UZ`f w z S' Contact's Telephone Number: L2 —'D 50 ~ S.2,:S rl Contact'sEmail: I J 1 ' 1i M0 9JXK-<0 Al 6 1 C, l> M GC / f C OM Legal Description of Property: s i _q J 5yi i—y s -C c7o iU )--1 i_ 610 N e 17 Section #:M ITown #: N Range #: W Town of. y *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. Tax ID # (1-5 digit number; found on tax statement): Proposed Use of Structure/Addition: 5 / OK 4 C L -- Anticipated Start Date: -� 1)iy (Home/Cabin; Commercial Business: Bedroom; Deck; etc.) Building Contractor: 1401re aid/IA Sewer Installer: N01V t - AREA BELOW THIS LINE FOR LAND SERVICES STAFF CONLNIEtiTS/CONDITIONS ONLY THIS PERMIT IS SUBJECT TO ALL/CONDITIONS /L/ISTED BELOW: y Date of staff site visit: 6 - a & " I `t Initials of site visit staff - PERMIT APPROVED BY LAND SERVICES IIX%0owGQ'llom UPON APPROVAL: APPLICANT MUST POST COPY OF SIGNED PERMIT APPLICATION IN PLAIN SIGHT Page 1 of 4 Burnett County, WI Land Use Application — Rev 3/2018 --i car Ir ::� i i Fee Rec:�