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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 $3001 Addition/Alteration to Dwelling/Principal Structure $200 <br />Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br />IKAccessory Structure (Garage, Shed, etc.) $150 Addition/Alteration to Accessory Structure $150 <br />Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br />Driveways/ & Campground Structuret$150 <br />$125 WI State Statute 59.692(1v) Structures $350 <br />Filling/Grading Boathouse $50D <br />Six Month Camping Unit (One Per Year) $100 Permit Extension (1 Year Extension - Allowed Once) $100 <br />*NOTE: After -the -fact permits (permit aquired afte r oonstru ct i on 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: <br />Property Owner's Mailing Address: e 130A 113 ANLuVLA-L7-7 Is—Yva <br />Property Site Address: Q' L % Ci State Zi j� <br />Contact's Telephone Number: 7J5— 760 ^ 6 2 J <br />Contact's Email:� krI V-- "r^, f �-`kA,3V :C` . �— <br />Legal Description of Property: 100 Z,5 t -q %/JIE <br />Section #: l & Town #: L1*0 N Range #: / 7 W Town of: �1Xrf - <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): O LIN �z l <br />Proposed Use of Structure/Addition: <br />Anticipated Start Date: �% ' �.�" (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <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 />Date of staff site visit. Initials of se visit staff: <br />PERMIT APPROVED BY LAND SERVICES OFFICIA DATE: <br />UPON APPROVAL: APPLICANT M T POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Transcendent: - Page 1 of 4 <br />Laserfische: - Burnett County, WI Land Use Application — Rev 8/2018 <br />a <br />o� <br />a <br />r <br />!1y <br />r-� <br />BE <br />0 <br />0 <br />0. <br />CS <br />w <br />N <br />0 <br />n <br />Fee Rec: /S'0, o0 <br />Check #d / 10 <br />41- <br />