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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 $200 <br />Commercial/Industrial Structure 3 Addition/Alteration to Commercial/Industrial Structure $200 <br />Accessory 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 Structures $125 WI State Statute 59.692(1v) Structures $350 <br />Filling/Grading $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 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 />t <br />Property Owner's Name: �O £ S C {' Q. <br />Property Owner's Mailing Address: <br />City State Zip <br />Property Site Address: <br />Contact's Telephone Number: `� ( L4 — 199 (� <br />a i <br />Contact's Email: _��(,1 r P (G Q X C I T >° i Corn <br />Legal Description of Property: Lo 44 \Sol . Z, Q fog 11 z�- <br />Section #: 3 2-- Town #:�5 9 N Range #: W Town of: SQl v-) <br />*Attach additional page if needed for lengthy description OR attach a copy gfthe deed OR attach tax system property page. <br />Tax ID # (1-5 digit number; found on tax statement): / 7376 <br />Proposed Use of Structure/Addition: S a�e ear. — 4 I <br />� � <br />Anticipated Start Date: 10 ome/Cabin; Commercial Business: Bedroom; Deck; etc.) <br />Building Contractor: Sewer Installer: t"/ <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />o � ��:, , -, s 1 6J,af k� ) I I /ao 1 B <br />f <br />y <br />Date of staff site visit: / J Initials of site visit staff: <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: { ^ ' " DATE: <br />UPON APPROVAL: APPLICANT MUST 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 />