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• <br /> r <br /> LAND USE PERMIT APPLICATION—Burnett County,WI " <br /> b <br /> Applicant Complete All Sections Below This Line E. N o <br /> a. <br /> d N <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $2006....- 0 <br /> ✓ Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 W A <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 G� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 14 <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 n <br /> *NOTE:After-the-fact permits(permit aquired 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. o 0_ r <br /> t /� <br /> Property Owner's Name: (j Q.''1 (\f\d1/4 bov'i i A 1�(/l,f- ., o <br /> P 0 )O I tL -D bJr Ui 1 548.30 Q <br /> L. <br /> Property Owner's Mailing Address: ° <br /> .^� _ f'� !',,,,� _} ity State Zip r�'„ tw <br /> Property Site Address: IIIJ �1�,1n100�he, , OuAlo '(.t 1(�ren5hIp C 10 <br /> Contact's Telephone Number: �« 5111 3 "l (1,1Cbor�h p m 3) 1 ".; o a <br /> Contact's Email: 6/atCif yl(it O `ti--mai I. Co vu CD <br /> a - <br /> 'D 131 <br /> iMI <br /> Legal Description of Property: ©0 K I M U S hO re 5 1 LOf I3 I N `� <br /> 5. <br /> Section#: Town#: N Range#: W Town of: ao <br /> C. <br /> 5. <br /> *Attach additional page if needed for lengthy description OR attach-f Las copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): 6 b 3 A. r.„ <br /> Proposed Use of Structure/Addition: Store Coors N2 ' <br /> p K <br /> Anticipated Start Date: ( -xt- r-O 30 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) d 8 <br /> Building Contractor: IVpr-1"h 1Gta [)t)i Li1y1�6 `Ifs( Sewer Installer: n 0116 1 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ^) <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 4 N \--Of g a vv\o.Y\ ‘:-\a-10 i`'-4:--t-i-t`0 IA z <br /> 'C9 -' b 0'4 e\,e 5 c I s Cr '�‘ eq` <br /> W ��G\ �Qtc1� a1J <br /> Fee Rec: t oll <br /> E. Check#: .2 3'x'7 <br /> c o <br /> Date of staff site visa 'f / Ini 'Ms of site visit staff: y v, r <br /> APPROVED BY LAND SERVICES OFFICI DATE: 6 Ap, i 4 <br /> < .... C...;... <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF3 G� <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT oz is <br /> c- N . N <br /> Transcendent: - Page 1 of 4 ' o°c o <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2020 < 4:1Q <br /> o 3 <br />