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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 $300 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 I Bunkhouse $250 <br />Driveways/ & Campground Structures $125 1 WI State Statute 59.692(1v) Structures $350 <br />Filling/Grading $150 1 Boathouse $500 <br />Six Month Camping Unit (One Per Year) $100 1 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 />Property Owner's Name: S h a ,.� n I 1 4(—' <br />Property Owner's Mailing Address: 7 % 7T 4 C, u, C D l :(I Af <br />City State Zip <br />Property Site Address: N1. S'f88 4 <br />Contact's Telephone Number: 7�� �� w -3y <br />Contact's Email: S6.rQC / e) , Lr„21 <br />Legal Description of Property: -5 E t,J SE <br />Section #: 2 Town #: N Range #:1�W Town of: <br />*Attach additionalpage 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): /I 3 Z 3 <br />Proposed Use of Structure/Addition: �- c CLCV— <br />Anticipated Start Date: I—Lo —11% (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: —5OAW A 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 OFFICIAL: e DATE: <br />UPON APPROVAL: APPLICANT MUS 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 />n I(LCD <br />�m <br />5 <br />r <br />a <br />O <br />CD <br />CD <br />`\ C1^ <br />M V <br />o <br />co <br />CD <br />o <br />o <br />°o <br />b <br />N <br />IY <br />CD <br />a <br />d <br />iD <br />o va <br />aro <br />0 <br />y <br />V � � <br />1, J <br />z <br />z <br />y Fee Rec: 01 e <br />x <br />Check #: 3 2 % ( <br />