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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line B o <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> n <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 cO <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 b <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r <br /> ' e <br /> Filling/Grading $150 Boathouse $500 o <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(l Year Extension-Allowed Once) $100 C' <br /> a <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. 5 <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. m <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- E <br /> Property Owner's Name: //1.'l4 tILtI $J? Jt „ o • <br /> Property Owner's Mailing Address: 2 S7Z f” aid 3f 1.6 SI'vv w, C-W97 <br /> City State Zip E. <br /> Property Site Address: 2(7z y B/, 3r 4/eipit r w%.- s— VIII <br /> 0 <br /> Contact's Telephone Number: 7/r, s-&&. /Gor H _a <br /> d <br /> Contact's Email:y FL,.,4„ CP AN,;e g,...1,C.., <br /> Legal Description of Property: ZS"72 y0/d 3 r sec_ ZO T.. 39 gy/G S VG 7,-f wy67,1.4wJ4/ <br /> Section#: 2 D Town#: 3, N Range#: / e W Town of: rift Cw^ o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* q <br /> E) <br /> Tax ID#(1-5 digit number; found on tax statement): //G#'Z <br /> a <br /> Proposed Use of Structure/Addition: 1714 44,c, 0 k <br /> Anticipated Start Date: T✓n[ zp (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ° <br /> Building Contractor:/Le (,,, 44e/ (#4.,/o r Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO AL ONDIT QNS ISTED BELOW: <br /> t, N*f a(2. C'�\A'MAY\ ��� t l5 N :.3 <br /> s Fee Rec:�-w <br /> Check#: 2 Q 2 g <br /> • f� t- <br /> 111/4)\Y— <br /> z> <br /> Date of staff site visit: • / ��__ In' sof site visit staff: <br /> z 0 <br /> APPROVED BY LAND SERVICES OFFICIA TE: ✓ D un <br /> < _Q <br /> UPON APPROVAL: APPLICANT MUST POST OPY OF y a �.� =-hNw <br /> CI <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z CD c N 5 <br /> Transcendent: - Page 1 of 4 m °e N <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 < oi..z C <br /> rrl 5. caa <br /> 2 5 <br /> a <br /> ro <br />