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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 <br />$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 />$150 <br />Six Month Campine Unit (One Per Year) <br />5100 <br />ition/Alteration to Dwelling/Principal Structure <br />ition/Alteration to Commercial/Industrial Structure <br />ition/Alteration to Accessory Structure <br />ition/Alteration to Bunkhouse <br />State Statute 59.592RA Structures <br />it 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 />*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 />'roperty Owner's Name: t✓ P. S �` i1 z <br />)roperty Owner's Mailing Address: <br />'roperty Site <br />State Zip <br />d <br />$350 <br />$500 <br />$100 <br />'.ontact's Telephone Number: 5--�J l7 <br />ontact's Email: -rC- G D^Z- Cti, (',CP fZ,(�(/�, <br />SY2 <br />,egal Description of Property: tou- L(i� (= i�CSC-"f -X20 /( %Z 1t(1 <br />i <br />lection #: Town #: I `N Range # _W Town of: AQ:e 4 j'GC-a <br />Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />Fax ID # (1-5 digit number; found on tax statement): .35-e5 <br />Iroposed Use of Structure/ dation: a�� �" r� (-aL _ S E L C f <br />knticipated Start Date: - ---Qi) 1,V (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />3uilding Contractor: o A5-ut4L it A t11 1L.#v Sewer Installer: <br />UREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />)ate of staff site visit: 1 i Initials of site visit staff: <br />IERMIT APPROVED BY ZONING 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 1/2018 <br />ln9 <br />C� <br />z <br />S <br />x <br />i t7 <br />w <br />Fee Rec. �nz) <br />ckec,K-A- -73OF <br />co <br />0 <br />N <br />N <br />14 1 jY, <br />)ate of staff site visit: 1 i Initials of site visit staff: <br />IERMIT APPROVED BY ZONING 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 1/2018 <br />ln9 <br />C� <br />z <br />S <br />x <br />i t7 <br />w <br />Fee Rec. �nz) <br />ckec,K-A- -73OF <br />co <br />0 <br />N <br />N <br />