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LAND USE PERMIT APPLICATION — Burnett County, WI I <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Please, check appropriate boxes) <br />Dwelling/Prinripal Structure <br />$300 <br />Addition/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure <br />$300 <br />Addition/Alteration to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) <br />$150 <br />I <br />Addition/Alteration to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial)$200 <br />Contact's Emaii: <br />Addition/Alteration to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Bunkhouse <br />$250 <br />Driveways/ & Campground Structures $125 jWl State Statute 59.692(1:v) Structures $350 <br />Fillin Gradin $150 Boathouse $500 <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 after construction has begun) may cost up to three times the norml 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, landscopina, etc. <br />r7 <br />Property Owner's Name: ay) ►''L i cbe A l :e— —hro` <br />l <br />}� p <br />Property Owner's Mailing Address: 2 1J211�u ( 540 30 <br />8 <br />t+ <br />Property Site Address: �,1 Cit State Zip <br />Ln--e— <br />� ��Z �n L -T1r> l <br />--I <br />� � <br />o <br />c <br />Contact's Telephone Number: �,� \ \(J � b�� Ce -0 <br />Contact's <br />Contact's Emaii: <br />Legal Description of Property: L-042) C S m V i <br />Section #: Town #: N Range #: W Town of: an <br />_ <br />q <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />n <br />Tax ID # (1-5 digit number; found on tax statement):�\S <br />Proposed Use of Structure/Addition: V��'S <br />`. <br />Anticipated Start Date: t -i t (HomelCabin:<ommercial BusBus nt�ess-1 Bedroom: Deck; etc.) <br />p c� it -'7-i y R � <br />"�P <br />S " 1 <br />Building Contractor: r� — r c` Sewer Installer© <br />AREA BELOW THIS LINE FOR LAND SERVICES F COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO AL CONDITIONS LISTED BELOW: <br />re✓ePerGUP o,� /o -a-18' <br />z <br />P R 0 'VE 0" <br />Fee Rec; <br />n <br />Check #: <br />q <br />Date of staff site visit: /' a 0 � fig' Initials of visit a � S <br />y <br />6 <br />z <br />V <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE: /D •9-� <br />UPON APPROVAL: APPLICANT MUST POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Transcendent: - Page 1 of 4 <br />X <br />R <br />`=? <br />c <br />Laserfische: - Burnett County, WI Land Use Application — Rev 8/2018 <br />.1�) <br />