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f LAND USE PERMIT APPLICATION - Burnett County, WI = c
<br /> _ E. Pip
<br /> Applicant Complete All Sections Below This Line g.
<br /> +,ermit types and Fees:(Please,check appropriate boxes) G.
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<br /> .lweinne/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 :.>
<br /> i.orninercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 _
<br /> • e-.•.or.structure(Garage,Shed,etc.) 5150 Addition/Alteration to Accessory Structure $150 L
<br /> - • .e: ‘)rn,cture(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150
<br /> ;tali:Il atIo�/Retai ing W� 5idf�waaIIkQ Bunkhouse $250 c
<br /> ' ,Cvsi tip amp;ound Structu es 125 WI State Statute 59.692(1v)Structures $350
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<br /> :,railing $150- Boathouse $500 — cj
<br /> month Camping Unit(One Per Year) S100 Permit Extension(1 Year Extension•Allowed Once) $100 6
<br /> NOTE:After-the-tact permits(permit aquired after construction has begun)may cost up to three times the normal fee.
<br /> ,,mmunrcatron lowers&Signs require o different application form;see corresponding application,and fees.
<br /> cps nor listed above will he treated as accessory structures,' such as:pergolas,landscaping,etc. ? II
<br /> •,r:'r". I Its.!ICI' \;iltic -CQ L_ND.r, d fir— Jo._C_K SG•P S
<br /> !-'\ t rt'.Ii i \lailin!_ Address: 4$ f C "r-4 j �Gll 0--a- A'1 Ti R.,e,
<br /> City State Zip
<br /> ,,,._..,i, ,ilc uttire : Kp�`\es~v-C L—e- _K-Q -\ L� S�Pr W I 5 �,1= J
<br /> i b. - I elerhone Number:_7/ S^ 8<cs(•:., — 'j 9 o9 ` _
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<br /> ..ii ;'t..crinlitin lit'Propert,:
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<br /> 1., n 3(ram I ass n n: y _N Range#: /5 W Town of: T S®,
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<br /> ,, ,::,trrnr,tr t,aw-o uretletl tor leuytln.description OR attach a ropy o/the deed OR attach tax system property pti,e.* q
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<br /> ' !I " Wei( number: found on tax statement):
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<br /> ,, i. -c ui structure/Addition:
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<br /> Ill Ic itijtc'tl stall I MR:: (dome('akin:Commercial B/nine./s:Bedroom.-Deck.etc.) 5
<br /> 'ni,nne t ,,Itu,ictor: Sewer Installer: _
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<br /> IRE:\ BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY
<br /> (FIBS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW:
<br /> ,art tle;•t1a ro contact their I I)('Inspector to determine if a permit is needed front theta prior to d
<br /> • ,non irritate plut'e•Joe our dwellings, duelling additions.
<br /> ,,uaanufact ur 11
<br /> e'd homes., manufactured z
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<br /> ,; rru iot�t�rr,�+„ttst.. (le/ 1 t C69 OTC + �►;r�(J 1J1 wY ON z
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<br /> Fee Rec:
<br /> ( ? Check A:
<br /> tae eit statt site ‘isit:7/? `7 ` ' Initials of s' visit staf /
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<br /> I'PRO�'FD BY LAND SERVICES OFFICIAL: DATE: �` a ( `1
<br /> UPON APPROVAL: APPLICANT tUST POST COPY OF
<br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT
<br /> I.in,centiei,t - Page 1 of 4 x
<br /> a.enl.cnc: Burnett County, WI Land Use Application— Rev 12/2020
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