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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 be <br />Dwelling/Principal Structure <br />$300 <br />Addition/Alteration to Dwelling/Principal Structure <br />$2 <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 />Bunkhouse <br />$250 <br />Driveways/ & Campground Structures <br />$125 <br />WI State Statute 59.692(1v) Structures <br />$350 <br />Filling/Grading <br />$150 <br />Boathouse <br />$500 <br />Six Month Camping Unit (One PerYear) <br />$100 <br />jPermit 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 o different application form; see corresponding application, and fees. <br />*Items not listed above will be treated as accessory structures, such as: er olas, landscaping, etc. <br />Property Owner's Name:--�dl - -� N e (Sow,- - <br />Property Owner's Mailing Address: ,e vvr 11 I <br />City State Zip <br />Property Site Address: 3 0 O SCE -S 1APc,41' A"+ <br />Contact's Telephone Number: �' SO 7 - ;z6 i - eS7 7 <br />Contact's Email: 'ir�,rQGe- ov"`- <br />�/Vt�t4 <br />Legal Description of Property: fW,x yye- .�/A4-1-oy-- �>��v—lo> , t oy 3T' <br />Section #: J7 Town #:__Yt N Range #: /,6- W Town of. 5/C55 <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): (5;L977 <br />Proposed Use of Structure/Addition— <br />Anticipated Start Date:_ �., j _ (Home/Cabin, Commercial Business; Bedroom; Deck; etc) <br />_�f <br />�- ��}} e <br />Building Contractor: I c�r� LOK S Sewer Installer: ° �^ ;/ a <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THISPERMITIS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />/ l <br />16 <br />Date of staff site visit: Initi Is of sitetvi it staff: <br />Pi 1'yl <br />i <br />q1 <br />9 <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: DA E: II r <br />UPON APPROVAL: APPLICA 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 />NA <br />°o <br />a <br />4 <br />m <br />r <br />-Z <br />a � <br />o <br />m <br />o�M <br />obi <br />W <br />o N <br />z <br />d� <br />LA <br />ti <br />1 <br />CA <br />x <br />Qd <br />z <br />lT1 <br />Fee Rec: <br />Check #: 3.3 <br />R1 <br />0 <br />W <br />n <br />r <br />r <br />w <br />7 <br />Q <br />Cn w <br />rTl <br />C <br />Co <br />IU{�ur1111 <br />o <br />v3cm <br />Na <br />io <br />