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LAND USE PERMIT APPLICATION – Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Please, check appropriate boxes) <br />Dwelling/Principal Structure $300 <br />Commercial/Industrial Structure <br />$300 <br />Accessory Structure (Garage, Shed, etc.) <br />$150 <br />Accessory Structure(Commercial/Industrial) <br />$200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Driveways/ & Campground Structures <br />$125 <br />Filling/Grading <br />Six Month Camping Unit (One Per Yea <br />Addition/Alteration to Dwelling/Principal Structure <br />Addition/Alteration to Commercial/Industrial Structure <br />Addition/Alteration to Accessory Structure <br />Addition/Alteration to Bunkhouse <br />Bunkhouse <br />WI State Statute 59.692(1v) Structures <br />Boathouse <br />Permit Extension (1 Year Extension - Allowed Once) <br />*NOTE: After -the -fact permits (permit aqui red 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. <br />Pronertv Owner's Name: ywl-y -H ixPP€RT <br />Property Owner's Mailing Address <br />Property Site Address: <br />0 <br />$200 <br />$200 <br />$150 <br />$150 <br />G� <br />$250 ° <br />$350 x- <br />$500 �A ° <br />$100 S <br />0 <br />2-8 ya'i K INS �}wZrftblyL's G1', DAN l3LtRy, w3 Sy 3 <br />City State Zip n <br />-710 l 9;4 w F-cw L-AA)� <br />Contact's Telephone Number: —71s— Z7-2-- 15V S <br />Contact's Email: JA p 11 I -s+erd-esi jtx Q od 100K. & m <br />Legal Description of Property: y0+ 21, 13LK 11 DA KL -A nl D S110K—k S <br />Section #: leo Town #: ND N Range #: 14, W Town of: OAK UtN 11 <br />*Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page.* <br />Tax ID # (1-5 digit number; found on tax statement):_ 1y$ 733 <br />Proposed Use of Structure/Addition: (�pAhj_-ESTDP,A0 <br />Anticipated Start Date: (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor:&)iQ(zTm l -A A t�:, P ►WLDTKs Sewer Installer: <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />_ J � <br />Date of staff site visit: D 3 <br />PERMIT APPROVED BY ZONING OFFIC <br />of site visit staff: <br />&A <br />DATE: <br />'ON APPROVAL: APPLICANT N11 <br />T POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page 1 of 4 <br />Burnett County, WI Land Use Application - Rev 1/2018 <br />Iz <br />0 <br />c <br />f <br />p� <br />x <br />E5 <br />O1� <br />� <br />z <br />5 <br />Cis <br />Fee Rec: <br />iso <br />