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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 d$200Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure Accessory Structure (Garage, Shed, etc.) $150 Addition/Alteration to Accessory Structure Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse Deck/Stairs/Patio/RetainingWall/Sidewalk -� <br />74 Driveways/ & Campground Structures Motute 59.692(1v) Structures $350 <br />Filling/Grading 1 $150 lBoatfiouse $500 <br />Six Month Camping Unit (One Per Year) $100 1 1 Permit Extension (1 Year Extension - Allowed Once) 1$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:_54JEL. L4000 <br />- <br />Property Owner's Mailing Address: "/4*Al <br />City State Zip <br />Property Site Address: SwE A6}t <br />Contact's Telephone Number: (#c ao 1 o ?j <br />Contact's Email: n . I Q. �m�i <br />Legal Description of Property: 1401F, 14 bt La I Y& hAanulo, <br />Section #:s (� Town #:_{!_N Range #: 14 W Town of: 500fT <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): 18874--- <br />Proposed <br />1 ElleProposed Use of Structure/Addition: 1A W i"dcallo <br />-7 <br />Anticipated Start Date: WK52 T (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: A'tq Sewer Installer:_ i/A <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />r APPROVED <br />Date of staff site visit: �` :4 Initials of site visit staff: <br />PERMIT APPROVED BY ZONING OFFICIAL DATE�� <br />UPON APPROVAL: APPLICM4 MUST POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page I of 4 <br />Burnett County, WI Land Use Application — Rev 1/2018 <br />Ir <br />0 <br />0 <br />a <br />a <br />N <br />0 <br />5• <br />ra <br />C7 <br />S. <br />s. <br />Fee Rec: i <br />ou <br />C= <br />00 <br />