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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 Addition/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure $300 Addition/Alteration to Commercial/industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) $150 Addition/Alteration to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse <br />$150 <br />IfDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse <br />$250 <br />Driveways/ & Campground Structures $125 WI State Statute 59.692(1v) Structures <br />$350 <br />Filling/Grading $150 Boathouse <br />$500 <br />1$100 <br />Six Month Camping Unit (One Per Year) $100 Permit Extension (1 Year Extension - Allowed Once) <br />*NOTE: After -the -fact permits (permit aquired after construction has begun) may cost up to three times the normal fee. <br />y <br />*Communication Towers & Signs require a different application form, see corresponding application, and fees. <br />*Items not listed above will be treated as accessorystructures, such as: peerrgollos,,llandscaping, etc. <br />Property Owner's Name: Ka I ii, V l 4, <br />Property Owner's Mailing Address: LL I q,5 ®c cel 3 e X 5 <br />27Rg7 t,, k� p City State Zip <br />Property Site Address: <br />4 <br />0 <br />m <br />N <br />°z <br />c� <br />Contact's Telephone Number:_ %15' 7 ! 2-7 <br />7' �t-5R% <br />Contact's Email: G(,( 'DhI ,Ilk <br />Ste" <br />Legal Description of Property: LD I CS/4y <br />o <br />a <br />3 <br />Section #: 25 Town #:b N Range #: /67 W Town of: <br />x <br />m <br />z <br />m <br />*Attach additional page if needed for 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): S&l op <br />Proposed Use of Structure/Addition: %��lace, '140) <br />Anticipated Start Date: (Home/ abin; Commercial Business; Bedroo Deck; etc.) <br />Building Contractorj�&l f77L4<.7lJ1 Sewer Installer: / V <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />X2011NIED <br />Date of staff site visit: 3 ' / — % Initials of site visit staff:_ . <br />PERMIT APPROVED BY ZONING OFFICIAL: <br />UPON APPROVAL: APPLICANT M <br />DATE:_ <br />T POST CO <br />SIGNED PERMIT APPLICATION IN PLAIN SIGH <br />OF <br />Page bf 4 <br />Burnett County, WI Land Use Application — Rev ' 2018 <br />E <br />0 <br />r <br />0 <br />r <br />0 <br />In <br />o <br />a <br />5' <br />as <br />0 <br />�1 <br />n <br />o <br />f <br />a C7 <br />y <br />z <br />yy <br />Fee Rec: <br />4 <br />0 <br />m <br />N <br />°z <br />c� <br />W <br />Ste" <br />9n � <br />o <br />a <br />3 <br />0 0 <br />Z 00 <br />x <br />m <br />z <br />m <br />