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• LAND USE PERMIT APPLICATION — Burnett County, WI <br /> Applicant Complete All Sections Below This Line c O <br /> Permit Types and Fees:(Please,check appropriate boxes) � c <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 .--e <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 '"ti <br /> X.Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 4 i1 <br /> c <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 o <br /> tn 0- <br /> '*NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. t <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> 7•-• <br /> *Items not listed above will be treated as ac essory structures,such as:pergolas,landscaping,etc. <br /> I CDr <br /> Property Owner's Name: �A U i fi 1 /l/`/kr r'1-1-1 /'1'/14. ° <br /> / PAU// +tet v H�Property Owner's Mailing Address: t`I �T ' � 414 c17/7 X I <br /> Et,_City�1�1 � p BSTtl Sf> g� State Zip <br /> Property Site Address: �S !}�� K ID <br /> E. <br /> Contact's Telephone Number: o <br /> Contact's Email: /�MLl�41S/ 1 d6/,i1/r- , �vM 'Q <br /> iea <br /> Legal Description of Property: 0 -,332-8--^6q - 7 0 a-s=3'j R , S'2 G t-q 'Pp <br /> Section#: g'S Town#: 3 9 N Range#: /Cr, W Town of: 11'►5 fin 0 A °' <br /> oc <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): 5 <br /> Proposed Use of Structure/Addition: SI ‘),--:At(..'i / i , s%r,-:/k,+,)•„:.4/44.A.6 oz I to <br /> Anticipated Start Date: 3-. ' "o ^1 5 <br /> p t Hnme�`Cabin:Commercial Business:Bedroom:Deck:etc.) x <br /> Building Contractor: Fe COpalt.40PS ler-i-- Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: a <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes, manufactured I <br /> home additions,and bunkhouses.** <br /> --,..) ....„ 11-wwi <br /> " ' R".0. 17(3Y) <br /> 1 .! -- <br /> x Fee Rec:L'3`x—' <br /> ..•-• L - Check#: 5;-)-3.17 <br /> Date of staff site visit: d,c9, _ ' t. Is of site visit staff: D <br /> z <br /> APPROVED BY LAND SERVICES OFFIC�• L: E� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF D c W Z <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 2 ^' <br /> p o C <br /> Transcendent: Page 1 of 4 n 9 N C <br /> Laserfische: Burnett County, WI Land Use Application—Rev 6/2020 T 3 a <br /> 0 <br /> :./2 <br /> K f <br />