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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 <br />Addition/Alteration to Dwelling/Principal Structure <br />Commercial/Industrial Structure $300 <br />Addition/Alteration to Commercial/Industrial Structure <br />Accessory Structure (Garage, Shed, etc.) $150 <br />Addition/Alteration to Accessory Structure <br />Accessory Structure (Commercial/Industrial) $200 <br />Addition/Alteration to Bunkhouse <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Driveways/ & Campground Structures $125 <br />Bunkhouse <br />WI State Statute 59.692(ly) Structures <br />Filling/Grading $150 <br />Boathouse <br />Six Month Camping Unit (One Per Year) $100 <br />Permit Extension (1 Year Extension - Allowed Once) <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 acces ry structures, such as: Deri'las. landscaDina. dtc. <br />Property Owner's <br />Property Owner's Mailing Address: <br />Property Site Address: <br />Contact's Telephone Number: 15 <br />Contact's Email: <br />Legal Description of Property: <br />$200 <br />5200 <br />$1001 <br />Y <br />8 <br />„tea <br />Zip. <br />Section #: Town N Range #: W Town of: <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 state en0: 1 :2q q <br />Proposed Use of Structure/A iti <br />Anticipated Start Date: k" (Ho e/Cabin; Commercial Business(, �edr om; Deck; etc.) <br />nstaller: ( ' <br />Building Contractor: - Sewer I <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: <br />PERMIT APPROVED BY LAND SERVICES <br />Initialsof si a visit staff: <br />FICIAL• DATE: <br />UPON APPROVAL: APPLI <br />T 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 />C" <br />C <br />b <br />41 <br />00 <br />ps° <br />f <br />Vyi <br />CD <br />a <br />b <br />o � <br />�d <br />z � <br />r <br />Fee ReC":' o20d <br />Check #: I I <br />r <br />r <br />a, <br />D <br />I•n <br />Z <br />C'7 <br />CCD M D' <br />C-1.7 <br />1 jj <br />y0 <br />On <br />m <br />O <br />C_ <br />am <br />com <br />3 <br />b <br />