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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 />welling/Principal Structure <br />$300rAddition/Al <br />tion/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure <br />$300tion/Alteration <br />to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) <br />$150teration <br />to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) <br />$200tion/Alteration <br />to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Driveways/ & Campground Structures <br />$125ate <br />house <br />$250 <br />Statute 59.692(ly) Structures <br />$350 <br />Filling/Grading <br />$150house <br />$500 <br />1$1001 <br />Six Month Camping Unit (One Per Year) <br />$100it <br />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 accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: <br />Property Owner's Mailing Address:- 76 t( 9 <br />L6 -- <br />nn nn City State Zip <br />1Z <br />Property Site Address: �� GtSs`t /mac Ct.)L WIr- -12 y <br />Contact's Telephone Number: �`� `` o) t <br />Contact's Email: Q L d4" <br />Legal Description of Property: !V W -5 F-- 2y ! �%�� L/ y <br />Section #: 2 Town #: .V N Range #: j W Town of: ��.(��t>�O <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 stat ement): 1' kV1 <br />Proposed Use of Structure/Addition: <br />Anticipated Start Date: 40A-- L <br />Building Contractor: <br />G <br />(Home/Cabin: Commercial Business: Bedroom; Deck; etc) <br />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: 1 3 / Initials of site visit staff: �// <br />APPROVED BY LAND SERVICES OFFICIAL: DATE: T2-e9� <br />UPON APPROVAL: APP ICANT 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 1/2019 <br />