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LAND USE PERMIT APPLICATION — Burnett County, WI 0 <br /> - ro <br /> Applicant Complete All Sections Below This Line c o <br /> Permit Types and Fees:(Please,check appropriate boxes) °' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `�,,..1 'J <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 '' O <br /> f <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> v Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 _ <br /> G1 <br /> A Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 ,' <br /> Filling/Grading g g $150 Boathouse $500 C- <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> r <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. o O <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. <br /> Property Owner's Name CM Ad-S- <br /> 6C% 1 ff e...`(N J" ""',' z <br /> o <br /> Property Owner's Mailing Address: .'r'` .".,k, <br /> `1' \e �. `� \ '�` (, )Z i'ty , State Zip a i. <br /> Property Site Address: , ' .� ti. 8 .k L b cci, l <br /> 4 II <br /> Contact's Telephone Number: 61-1•59.-i ! q (TA) (0a-9 U w? 1 .- c o � •, <br /> Contact's Email: "Q iT1 VO I(;VC 4) C tt- 1 1 t It U 1Y1, 0 e <br /> L-t al escription of Property:r XI W',\n 58 ' t etk o bj r^�fN r 11 <br /> ��V <br /> �SII Ch \' Town#:7N Range#: /tu. W Town of: ' r °0 <br /> *Attach a iti•na page if needed for lengthy description 0' att ch copy of the deed OR attach tax system property page.* t7 <br /> f <br /> Tax ID#(1-5 digit number;found on tax statement): Or) C 9,46, k 4 0 1 i 01 -- <br /> Proposed Use of Structure/Addition: a\ i <br /> ' ' <br /> Anticipated Start Date: 91 \x) e 5 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) x <br /> c ,.� d <br /> Building Contractor 'L�-k1 N'�(�Y\ V b!h(✓ ) i Sewer Installer: <br /> 3-3 <br /> AREA BELOW THIS LLNE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <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 z <br /> home additions, and bunkhouses.** x <br /> _, r. <br /> Fee Rec: <br /> Ec Check#: <br /> Date of staff site visit: ✓ ni ials of site visit staff: a <br /> z <br /> APPROVED BY LAND SERVICES OFF AL: JATE�'— I c 2 O < r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF > . �: fi <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° 0 N <br /> Transcendent: - Page 1 of 4 " �°0' <br /> Laserfische: Burnett County, WI Land Use Application—Rev 6/2020 '' <br /> o J <br /> K <br />