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' LAND USE PERMIT APPLICATION — Burnett County, WI a a <br /> gb <br /> Applicant Complete All Sections Below This Line 6 c o <br /> Permit Types and Fees:(Please,check appropriate boxes) °' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ' O <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> x Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 "� F <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 r <br /> o — ` <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 Di <br /> *NOTE:After-the-fact permits(permit aqui red 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. q <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 0 <br /> Property Owner's Name: ,f I 0 Ov I v' ,4, 6ec.sid z V <br /> .ri Pi <br /> Property Owner's Mailing Address: 2-752-Z- 1144 IlS G r+ gyl Ility ki ROD °c ,,, <br /> City late Zip <br /> Property Site Address: Sq 01 € E n <br /> CA <br /> C <br /> Contact's Telephone Number: 7(0'3 22 Z .. 5 39 3 oc <br /> Contact's Email: b ��b! j�'l. ]�►Vb4/ y(,f Ado. Co 141o , <br /> Legal Description of Property: kf 111 ,60 to t(,14� L0# l <br /> ti <br /> / o ao <br /> Seel ction#: / j Town#: 6 © N Range#: /6 W Town of: Oak Q/l <br /> o-"*Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system property Page.* <br /> E. <br /> Tax ID#(1-5 digit number;found on tax statement): /1/9 o Z <br /> Proposed Use of Structure dditiot}: / • $ 4 �' <br /> t °' <br /> Anticipated Start Date: Q p a I �(j I (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) _ k <br /> J e <br /> Building Contractor: Sewer Installer: <br /> -i <br /> AREA BELOW THIS LLNE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> r— <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 0 <br /> home additions,and bunkhouses.** %n <br /> 11 b-1/4- -DQ- \•\-Way 44-461\0( <br /> Is- <br /> Fee Rec: 5 <br /> Check#:-. 0c2-4D <br /> ��6�C, T <br /> Date of staff site vis Initials of site visit staff: z <br /> APPROVED BY LAND SERVICES OFFICIAL: "��� DATE: 3—(;()C)-o <br /> n l' 5 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF CD = rs <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° N W <br /> Transcendent: Page 1 of 4 n .< NG7 <br /> Laserfische: Burnett County, WI Land Use Application— Rev 6/2020 m _� <br /> 0 <br />