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LAND USE PERMIT APPLICATION—Burnett County, WI cr i <br /> o: cn i� <br /> Applicant Complete All Sections Below This Line a cz <br /> Permit Types and Fees:(Please,check appropriate boxes) \ o <br /> w <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 i <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> /Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0° <br /> /( Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 w <br /> A <br /> *NOTE:After-the-fact permits(permit aqui red 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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 0 ‘ <br /> to z ', <br /> Property Owner's Name: u C.A if-••_r a 6, ° <br /> Property Owner's Mailing Address: "7(p 1 /6Y> 4 r 563oy $ <br /> City State Zip <br /> Property Site Address: g3 )-t) Co Pr—a> Ad We L5 (^)..-LT_ Syy ys '' <br /> •6 •o <br /> Contact's Telephone Number: (05/ -59,1- -�YeV a <br /> d <br /> Contact's Email: F utt✓� , 1%. AAIRI-co".. 89,r`�r ', G0`�` <br /> Legal Description of Property: 11,, 1144,4s o 4s f 4 ci; a,17c <br /> Section#: 3(1 Town#: 11.6 N Range#: R. 7 W Town of: Uel i a r ac <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> o" <br /> Tax ID#(1-5 digit number;found on tax statement): a 6-yo <br /> Proposed Use of Structure/Addition: Cc 4,A iQ,_k_ f k <br /> Anticipated Start Date: 9-/ - /1' (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) z G <br /> Building Contractor: PID r,.t, o.04..s r Sewer Installer: t AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> • /11 / )( 1 0 i deeyli--- zx <br /> i'Jo Q—)CaN-5 I cr u c'�-S Lo / <br /> P <br /> -i Fee Rec: (02 _ <br /> . 5 — <br /> r = <br /> Check#: -5�'s(o <br /> rr <br /> Date of staff site visit: / /II *s f site visit staff: - <br /> APPROVED BY LAND SERVICES OFFICI DATE: ���C7 x .----7„___,.. <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 0 <br /> CO <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Transcendent: - Page 0 <br /> Laserfische: - Burnett County,WI Land Use Application —Rev 1/2020 <br /> r <br />