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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 <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 />Addition/Alteration to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) <br />$200 <br />Addition/Alteration to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Driveways/ & Campground Structures <br />$125 <br />Bunkhouse <br />WI State Statute 59.692(1v) Structures <br />$250 <br />$350 <br />Filling/Grading <br />$150 <br />Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) <br />$100 <br />Permit Extension (1 Year Extension - Allowed Once) <br />$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 accesso tr ctures, such as: pergolas, landscap g, etc. <br />Property Owner's Name: k, r4r2 AJ <br />Property Owner's Mailing Address: <br />Cit tatt Zip <br />Property Site Address: dip\7 (A <br />Contact's Telephone Number: <br />Contact's Emai0lf 0-4lise..,e/`( "r—h�d- �, ne <br />Legal Description of Property: Z <br />Section #:.34 Town #:__I�N Range #: W Town of:-srt�'iSS <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 stat ment): 22 ys© <br />Proposed Use of Stnictur Addition "V- <br />Anticipated <br />Start Date: (Home/Cabin; Comm •tial Business: Bedroom; Deck; etc. <br />Building Contrac or: 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 />IV" <br />In <br />��J G t'T"e $ c7 r I' I IiW\O ri� <br />Date of staff site visit: �D- d y Initials of si visit staff - <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE: // -r je <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 />N <br />19.1 <br />12 <br />n <br />Fee Rec: ) S O <br />Check #: 16 411 <br />