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• LAND USE PERMIT APPLICATION - Burnett County, WI <br /> E7' c7 Applicant Complete All Sections Below This Lines. o <br /> i� d <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 )(Addition/Alteration to Dwelling/Principal Structure $200 o W <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 I on <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ' o O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 I , R <br /> n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ' a 0 <br /> Filling/Grading $150 Boathouse $500 r t <br /> o <br /> Six Month Camping Unit(One Per Year)) $100 Permit Extension(1Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. „,,g k <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: v o s e.4- S k >y I�y.- <br /> p 10 <br /> Property Owner's Mailing Address: I 2--7 CI-k i Yr 6 Q_. '`A i.3 S1 i K;,1,144. si g 6tfi o <br /> ` City State Zip -0 <br /> Property Site Address: 3 O O L c i>t r-.4",•\ {�,A ` S L o 1�' (A) 0 n <br /> Contact's Telephone Number: 1 i C - ?.-cl c\ -• 010 3 o E <br /> Contact's Email: ' \ S — -- v 1 ex 1 G c_ r 1 e# to ( c Min 4,” C--) a <br /> J A ' ` roreA d <br /> CD <br /> Legal Description of Property: IA c-K e-t,z+E- S Lc--t-S C---(-..'C---(-..' A o O n 1 l 5 c.n e �,4 t n+ .. <br /> N ao <br /> Section#: Town#: N Range#: W Town of: S L G-ti - <br /> C. <br /> P*Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system property page.* <br /> P <br /> Tax ID#(1-5 digit number; found on tax statement): 1 1 Z CI <br /> \ <br /> Proposed Use of Structure/Addition: Pt..tt ft rk .f&tndet J o1) � ' -' _' 4I Cr <br /> H <br /> Anticipated Start Date: c% 1 i� 2.02 <br /> / .0 � (Home Cabin Commercial Business;Bedroom;Deck;etc.) £ x <br /> izi <br /> Building Contractor: 30%-%r' I--'$4 1---='-I- c Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Cj <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.** <br /> F ' 5vV4ACka-4tan 5'i z To b-e- il -P--i)ec - (Ander a <br /> 1-9+ x as C� ecor1 14\e ko w- L ;4-h � <br /> j-rot <br /> I 1 Ce,".0.114€4, -k--0 be_ .T._001-- o-p crdo i yeice/fokNoir ofi <br /> i-p (1- cD <br /> a 1 o td �uthcVa� t 0 IV 5j , C� fYbT To £?.(C€'e�c� l / Sq t O Fee Rec: Z <br /> If �/ L ` 4 Check#: bl{/I <br /> Date of staff site visit: A 1 ! ��� In' ials of site visit staff: <br /> VVV z <br /> rl { <br /> U <br /> APPROVED BY LAND SERVICES OFFICI ‘:''e*'--- DATE: 0 - P1-49--D I l'...1 <br /> r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 2 ca L c <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° N T. <br /> r <br /> `< CO <br /> CDa AI <br /> Transcendent: Page 1 of 4 n a K - <br /> Laserfische: Burnett County, WI Land Use Application- Rev 6/2020 m 3 <br /> oi� <br /> U. <br />