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LAND USE PERMIT APPLICATION — Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />rA <br />Permit Types and Fees: (Please, check appropriate boxes) <br />Dwelling/Principal Structure $300 on/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure $300 on/Alteration to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) $150 to Accessory Structure <br />;Addition/Alteration <br />$150 <br />Accessory Structure (Commercial/Industrial) $200 on/Alteration to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk ouse <br />$250 <br />Driveways/ & Campground Structures $125 te Statute 59.692(1v) Structures <br />$350 <br />Filling/Grading $150 Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) $100 1 jPermit 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. <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 />Property Owner's Name: fil A/ ru U .J N <br />IL � jyli✓S �G <br />Property Owner's Mailing Address:/ l 7 %j6 Se's'✓ 6e,,r C % a jt't✓c.~+^ <br />�City State Zip <br />Property Site Address: �% 7 �/�' U � %��Cc' <br />Contact's Telephone Number: <br />Contact's Email: Kt� cT v✓ ke-AC(-- $,f"y • CG <br />1� <br />Legal Description of Property: ��T `S L <br />Section #: Town #: N Range #: W Town of:06-k1 ars.L <br />*Attach additionalpage if neededfor lengthy description OR attach a�coy of the deed OR attach toy system property page.* <br />1 <br />7 <br />Tax ID # (1-5 digit number; found on tax statement): <br />Proposed Use of Stnicture/Addition:S+O-�-A,,.-ac) ,-� 1 S x ac) <br />Anticipated Start Date: (Hone/Cabin; Commercial Business; Bedroom; Deck; ere.) <br />Building Contractor:-- Sewer Installer: <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />CLe1-t-S a., o W e J' f V-) <br />A . . cG�,rl/ c� v �rt-2S t!�$ r Q iz� <br />FA <br />Date of staff site visit: �3 Initials of 'te vis' s ff: �R <br />�, , 5/8//8 <br />PERMIT APPROVED BY LAND SERVICES OFFICIA • 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 />C" <br />c <br />00 <br />M <br />N <br />�-7C) <br />C <br />14+ <br />U <br />►� <br />x <br />Fee Rec: + J 0 <br />0 <br />m <br />