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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 />SZAccessory <br />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 />WI State Statute 59.692(ly) Structures <br />$350 <br />Driveways/ & Campground Structures <br />$125 <br />Filling/Grading <br />$150 <br />Boathouse <br />$500 <br />Six Month Camping Unit (One PerYear) <br />$100 <br />Permit Extension (lYear 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 accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: <br />Property Owner's Mailing Address: <br />City State Zip <br />Property Site Address:.��' 0 y <br />Contact's Telephone Number: <br />Contact's Email: <br />Legal Description of Property: <br />Section #: / 3 Town #: Yl Al N Range #:j (,o_W Town of: S S 3 <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />, <br />Tax ID # (1-5 digit number; found on tax statement): �/ iJ 15 <br />Proposed Use of Structure/Addition: <br />Anticipated Start Date: Apf4 l A- / (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: 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 />Nd �u mon q/le we al let Ty <br />Date of staff site visit: 2 / / Initials of site visit staff: <br />APPROVED BY LAND SERVICES OFFICIAL: DATE: <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 1/2019 <br />b C' <br />� c <br />w <br />C <br />a <br />O <br />F <br />CD <br />0 <br />` O <br />o <br />o <br />z <br />o <br />o N <br />c <br />a <br />C7 <br />m <br />X <br />� d <br />N <br />r <br />Fee Rec:1 <br />Check #: <br />