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LAND USE PERMIT APPLICATION - Burnett County, WI a g <br /> Applicant Complete All Sections Below This Line 0 m o <br /> Permit Types and Fees:(Please,check appropriate boxes) a i <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ?; , 1 <br /> CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ",...D <br /> 6-0 <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 rc- <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 c <br /> n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °< <br /> Filling/Grading $150 Boathouse $500 r. A <br /> Six Month Cam Unit One Per Year ° <br /> in <br /> p' g ( ) $100 Permit Extension(1 Year 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. = <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. 'c? a <br /> Property Owner's Name: CMM yTp 74 j« ° z , <br /> 9 <br /> Property Owner's Mailing Address: 7637 d� k- DjF,v3r-,p - CC), _ 5-4?3,3 o <br /> City State Zip $ <br /> Property Site Address: _.S l4/47 F. n <br /> c4 <br /> Contact's Telephone Number: 4./12 — �� 7_ ift r4, o• G <br /> CD <br /> Contact's Email: C. items e 1.1.&&- Q°_,..14.04/ C�h,, a <br /> e <br /> Legal Description of Property: �O" AN� '1,...tS�e, a k r 3 <br /> 0 00 <br /> Section#: Town#: l N Range#: t (, W Town of: S' I .S S' <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> Tax ID#(1-5 digit number; found on tax statement): A1/2" 72¢,i5' `P,. 4n �`'�c <br /> Proposed Use of Structure/Addition: 6'14 testi- E. <br /> w <br /> Anticipated Start Date: ?_ 3— /e7o(Home/Cabin;Commercial Business;Bedroom;Deck;etc.) K <br /> Building Contractor: r E. £.-P Sewer Installer: /Yd9NNE U. <br /> -3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMVIMENTS/CONDITIONS ONLY C W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: N�cn 0 <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 /> Fee Rec:hU <br /> 7 Check#: 119 I <br /> ?--3 0-o I t- <br /> Date of staff site visit: Initials of site visit staff: a <br /> APPROVED BY LAND SERVICES OFFICIAL: MIDATE: l — G a-a <x =cal 1 31) <br /> r—- -6 ._„) <br /> UPON APPROVAL: APPLICANT MUST POST COPY OFMit <br /> _( r_.. <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0,G `=' <br /> Transcendent: - Page 1 of 4 s"i o <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 6/2020 < ( 11-111j <br /> 0 <br /> D <br />