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LAND USE PERMIT APPLICATION — Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Permit Tvoes and Fees: (Please. check <br />Dwelling/Principal Structure <br />$300 <br />Addition/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure <br />$300 <br />Addition/Alteration to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) <br />$150 <br />Addition/Alteration to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) <br />$200 <br />Addition/Alteration to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Driveways/ & Campground Structures <br />$125 <br />Bunkhouse <br />WI State Statute 59.692(1v) Structures <br />$250 <br />$350 <br />Filling/Grading <br />$150 <br />Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) <br />$100 <br />Permit Extension (1 Year Extension - Allowed Once) <br />$100 <br />*NOTE: After -the -fact permits (permit aquired after construction has begun) may cost up to three times the normal fee. I <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, landscaoina, etc. <br />r <br />Property Owner's Name: r <br />Property Owner's Mailing Address:) <br />Property Site Address: <br />Contact's Telephone Number: 76 <br />S tr�2vo�c�n l e- �r i� <br />n . 1 City <br />15E33 <br />State Zip <br />Contact's Email: Isivi i 01,b) e tes IN1S=10Qiy1Cx torn <br />Legal Description of Property: �� S <br />Section #: P Town #:4LN Range #:��W Town of. ©glc- 4 <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 <br />Proposed Use of Structure/ ditio • <br />Anticipated Start Date: <br />Building Contractor: <br />(Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Sewer Installer: <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Date of staff site visit:5 Initialsof ite visit staff: <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE: <br />UPON APPROVAL: APPLICANT MUST POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page 1 of 4 <br />Burnett County, WI Land Use Application — Rev 3/2018 <br />•n <br />b <br />00 <br />I <br />7 <br />O <br />VN <br />0 <br />m <br />Fee Rec: 7L <br />a"t31ay <br />