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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 />Bunkhouse <br />$250 <br />Wl State Statute 59.692(1v) Structures <br />$350 <br />Driveways/ & Campground Structures <br />$125 <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 aqui red 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 />�' P.L�rilt.e.,►M P,,4 <br />Property Owner's Name: (Aloa 1 A k� C��., ? � ��..� . <br />Property Owner's Mailing Address: ) q ?)O/tit _S'5-0 <br />p N City State Zip <br />ff� <br />Property Site Address: rK� K ` w L J1 fr=! 3tib <br />Contact's Telephone Number: M W7 <br />Contact's EmaiL•_ 4 o•ro,AL 49— G . �,,)Jntj (� c � c, . e o v✓� <br />Legal Description of Property: _ Y�' N-4'-N en /v I O0Z <br />Section #:— Town #: S 7 N Range #:_18' W Town of: -Fraa�- <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />03 Z ?-ax <br />Tax ID # (1-5 digit number; found on tax statement): <br />Proposed Use of Structure/Addition: ..5�-orrane <br />Anticipated Start Date: G - . A019 (Home/Cabin; Commercial Business; Bedroom; Deck; etc) <br />Building Contractor: Cow S k^A-C ) d,-j SewerInstaller: <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDI/TIONS LISTED BELOW: <br />/I�e�e-4' 7� O.��G � � a s / �- 2�/ass �' y' �'�► i s <br />-- q <br />�a rce,l y 7% //2 <br />Date of staff site visit: -5-/ / / Initials of site visit staff- <br />APPROVED BY LAND SERVICES OFFICIAL: DATE: ✓`� �S <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 r <br />� b <br />;P <br />a. <br />d <br />m <br />P <br />r <br />0 <br />m <br />m� <br />z <br />0 <br />n <br />o y <br />0 <br />b <br />00 <br />o � <br />y <br />W <br />z <br />N <br />Fee R c: <br />Check #: -5c)-3 <br />M <br />n <br />0 <br />W <br />Um <br />