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LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> E: <br /> ro <br /> Applicant Complete All Sections Below This Line 5- o <br /> Permit Types and Fees:(Please,check appropriate boxes) D F U <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> d <br /> CD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `"U <br /> Accessory Structure(Garage,Shed,etc.) $150 1r Addition/Alteration to Accessory Structure $150 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 `-0 g <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 `��� ` <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° DJ <br /> Filling/Grading $150 Boathouse $500 r- N <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> o Cj <br /> c4 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. 11) <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 /> ro <br /> r' g i <br /> PropertyOwner's Name: -6V-kb RE3 Et.)P‘1?---- 0 <br /> z.-4,. <br /> Property Owner's Mailing Address: ^ y0 Li Nlb S PI ' 14UtDSo►S W s(FO':(0 0 <br /> �: ,1 3 E-l�l.-O � City State Zipin N <br /> Property Site Address: 1 <br /> Contact's Telephone Number: 83 2 SLl-S- OR \- o <br /> _. - (Q <br /> 16{0L-Al"i'Gb e v‘A-✓ € ak N�ou I 1 . co+►�. a <br /> Contact's Email: C> o <br /> CD <br /> Legal Description of Property: S to 4. 1"t k a 1 <br /> N ^0 <br /> Section#: Z.S Town#: {O N Range#: 11 W Town of: Liv 1 h n 0. °Q <br /> 5 <br /> ma <br /> *Attach additional page if'needed for lengthy description OR attach a copy of the deed OR attach tax system propertypage.* <br /> C7 <br /> Tax ID#(1-5 digit number; found on tax statement): 3344 ID R <br /> Proposed Use of Structure/Addition: b<-Lc.--- cn <br /> w <br /> Anticipated Start Date: �1 '20 o 20 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor:3tn.. 6..I GISOi Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: . ,..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 <br /> home additions,and bunkhouses.** z <br /> x FeeRec: <br /> ,\ S <br /> Check#: a( ) <br /> tr <br /> Date of staff site visa J " �vap 'tials ,f site visit staff: k--- z <br /> I <br /> APPROVED BY LAND SERVICES OFFICIAL: ikat ♦ /(2,46�`/ r'15n r- <br /> m <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a ., m <br /> ""Cl <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° N to "' <br /> 0o <br /> Transcendent: Page 1 of 4 n ti " <br /> Laserfische: Burnett County, WI Land Use Application -Rev 6/2020 M _ — <br />