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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 />$1.50 <br />/ <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Bunkhouse <br />$250 <br />V <br />Driveways/ & Campground Structures <br />$125 <br />jWl State Statute 59.692(ly) Structures <br />$350 <br />Filling/Grading <br />$150 <br />1 <br />lBoathouse <br />$500 <br />Six Month Camping Unit (One Per Year) <br />$100 <br />1 <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 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: Dos-- h (/Ve�w r <br />Property Owner's Mailing Address: 2 3 0 s� Aw— aceola t%1.' S-41016 <br />Cit State Zip <br />Property Site Address: rt . D <br />90 /� r Z a,.g �. ru <br />n n / <br />Contact's Telephone Number: / (�ZZo " Z ! {a 0 <br />S�- �oa. <br />Contact's Email: <br />Oyu v tvP.Aiti.�,r"� �I Cow. <br />Legal Description of Property: I rl U14�4 <br />Section #: 080 Town #: 4/0 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 statement): Z'�� S(y <br />Proposed Use of Structure//� diti%n: beck <br />��.3/�9 <br />Anticipated Start Date: J (Home/Cabin; Commercial Business; Bedroom; Deck; etc) <br />Building Contractor: Du ff'ri7 tvft&ej/ 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: 7 h �Z/ / Initials of site visit staff: <br />APPROVED BY LAND SERVICES OFFICIAL: DATE: <br />UPON APPROVAL: APPL CANT MUST POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Transcendent: - Page I of 4 <br />Laserfische: - Burnett County, WI Land Use Application — Rev 1/2019 <br />Fee Rec:!L LCK� <br />Check #: <br />a <br />g <br />eo c <br />C= <br />