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C ro <br />LAND USE PERMIT APPLICATION —Burnett County, WI a <br />_C <br />y y <br />Applicant Complete All Sections Below This Line 0 <br />p <br />a <br />Permit Types and Fees: (Please, check appropriate boxes) w� <br />Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure ]$350 <br />Commercial/industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure _ <br />Accessory Structure (Garage, Shed, etc.) $150 Addition/Alteration to Accessory Structure CS <br />Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse <br />C) <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse �, ,C <br />Driveways/ & Campground Structures $125 WI State Statute 59.692(ly) Structures felFilling/Grading $150 Boathouse Six Month Camping Unit (One Per Year) $100 Permit Extension (1Year Extension - Allowed Once) *NOTE: After -the -fact permits (permit aquired after construction has begun) may cost up to three times the normal fee.9 <br />*Communication Towers & Signs require a different application form; see corresponding application, and fees. <br />*Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. t - <br />Property Owner's Name: (� (y�A% '�a ltlko Z <br />o' o w <br />Property Owner's Mailing Address: <br />�r _ City ,� / State Zip <br />Property Site Address: ,3 ;�j'� �j' G� �,L•� ��+I �5 /�� I?Iy y��� j� W/ C <br />3�g 2 <br />Contact's Telephone Number: -715- 5 2 8.5 C1 CD <br />a <br />Contact's Email: � <br />Legal Description of Property: TS 342, 31-65 P fi GIC' b/�I X15 T 3 3 0 <br />Section #: % ' Town #: L' N Range #: i S� W Town of /QC k$� o <br />r7 <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/Addition: r .5C yo574 p,� C rL o <br />Anticipated Start Date: W 1. [a '7-PZ0r! l % (Home/Cabin; Commercial Business; Bedroom,, etc.) O r ' <br />V <br />Building Contractor: ���,� �. Sewer Installer: 9 <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 01 <br />ell <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: a <br />pp z 5 <br />ADDDAVin <br />Date of staff site visit: Initials of site visit staff: <br />PERMIT APPROVED BY LAND SERVICES OFFICIAI!r <br />j o/1"l <br />DATE: /Iyl� <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 />--i Fee Rec: <br />C" <br />b <br />:v <br />k <br />d <br />W <br />610 <br />Check #: <br />e <br />rn <br />