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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 <br />on/Alteration to Dwelling/Principal Structure $200 <br />Commercial/Industrial Structure $300 on/Alteration to Commercial/Industrial Structure $200 <br />X Accessory Structure (Garage, Shed, etc.) $150 to Accessory Structure $150 <br />Accessory Structure (Commercial/Industrial) $200 on/Alteration to Bunkhouse $150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk ouse $250 <br />Driveways/ & Campground Structures $125 te Statute 59.692(1v) Structures $350 <br />Filling/Grading $150 1 lBoathouse $500 <br />Six Month Camping Unit (One Per Year) $100 I 1permit Extension (1 Year Extension - Allowed Once) $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: �r <br />Property Owner's Mailing Address: <br />City State Zip <br />Property Site Address: � m ea�� n 1� <br />Contact's Telephone Number: II� 3/ J Z <br />Contact's Email:�,e't SS e VU n 0 D' C b <br />i <br />Legal Description of Property: t7- <br />Section #:5 i Town #Tt�0 N Range #: 17 LV W Town of: 0 it, ( ID A/ <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): <br />Proposed Use of Structure/A ditio c! ' : Q �! Q 0,Ya �� � l a � x 3 a? <br />Anticipated Start Date: IH(4e/Cahin ommercial Business; Bedroom; Deck; etc.) <br />Building Contractor: C- I eu e- CL l A lw—� 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: <br />PERMIT APPROVED BY LAND SERVICES OFFICIA 4DATE:/a��/ <br />UPON APPROVAL: APPLICANT NWST 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 />r <br />b <br />00 <br />V <br />2 <br />s <br />0 <br />m <br />-o <br />x <br />� � x <br />7 <br />z ON, <br />z <br />Fee Rec. 156 <br />Check #: R83 G <br />�I <br />