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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 Camping Unit (One Per Year) <br />$100 <br />Addition/Alteration to Dwelling/Principal Structure <br />$200 <br />Addition/Alteration to Commercial/Industrial Structure <br />$200 <br />Addition/Alteration to Accessory Structure <br />$150 <br />Addition/Alteration to Bunkhouse <br />$150 <br />Bunkhouse <br />$250 <br />WI State Statute 59.692(1v) Structures <br />$350 <br />Boathouse <br />$500 <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 <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: perqolas, landscaping, etc. <br />Property Owner's Name:_ Wo r 4 n -e— <br />Property <br />Property Owner's Mailing Address: <br />L <br />City State Zip <br />Property Site Address:_ ] t f S �+ a S /� �c d f �ly /�> (J S Y ✓ /Y� <br />Contact's Telephone Number: 7 L 3- ;� a L- V ii- 7 0 J o h - 6 S 1' ? 1 `mss <br />Contact's Email: 3-- k Za-1%. cn1 MS+ n . C o ev' <br />Legal Description of Propertyy l U V. qe -,,Si��� o r' L <br />Section #: Town #: N Range #: W Town of 6•-M &Yuk - <br />*Attach additional page if needed for lengthy description OR attach <br />a copy of the deed OR attach tax system propertypage. <br />NTax ID # (1-5 digit number; found on tax statement): 1 1 J23 <br />Proposed Use of Structure/Addition: S t a. r S to (n k t <br />Anticipated Start Date:/ S� a of 7 (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: �jle ,�, �/ U ,n V / ti ,� f 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: Initials of site visit staff: SO <br />/ -- i -a7 <br />PERMIT APPROVED BY LAND SERVICES OFFICIA DATE: <br />UPON APPROVAL: APPLICANT MUST POST COPY OF <br />6 SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page 1 of 4 <br />Burnett County, WI Land Use Application — Rev 3/2018 <br />V <br />o <br />CD <br />w <br />U <br />►r <br />M <br />rn <br />w <br />a <br />�J <br />0 <br />n <br />b <br />� Nj <br />' <br />' ,7 <br />OG <br />r <br />77 <br />7T - <br />o <br />U <br />� <br />M <br />w <br />�J <br />0 <br />n <br />b <br />� Nj <br />' <br />9 <br />r <br />77 <br />y <br />a <br />G <br />r <br />d <br />N <br />_ <br />uo <br />% <br />5' <br />00 <br />d <br />Cn <br />o <br />� <br />k <br />G <br />a <br />C7 <br />_L <br />J� <br />un <br />P <br />z <br />z <br />� <br />W <br />Fee Rec: ail <br />s <br />d <br />