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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 />$300rAddition/Alteration <br />n/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure <br />$300n/Alteration <br />to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) <br />$150n/Alteration <br />to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) <br />$200n/Alteration <br />to Bunkhouse <br />$150Deck/Stairs/Patio/Retaining <br />Wall/Sidewalk <br />use <br />$250 <br />Statute 59.692(ly) Structures <br />$350 <br />Driveways/& Campground Structures <br />$125 <br />Filling/Grading <br />$150se <br />$500 <br />Six Month Camping Unit (One Per Year) <br />$100xtension <br />(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 •I ll /)- <br />Property Owner's Mailing Address: T w - tj t/ ►4fj <br />' CState <br />Property Site Address: 21�jd <br />� 3 <br />'y <br />"—r <br />Contact's Telephone Number: <br />Contact's Email` rv,4 e,��'✓� <br />Legal Description o perty: P D : 01 04 -40 0 I+00 V <br />Section #: Town #:��N Range #:—I�_W Town of: �Q, 4 /apQ/ <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />� -` oz3 <br />Tax ID # (1-5 digit number; found on tax statement): <br />Proposed Use Struc /Addiition: <br />of <br />Anticipated Start Date eWk41" ' �L-X L (Home/Cabin; Commercial Business; Bedroo ; Deck• tc) <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 />�- �e,� �oacs �,, �� �4 yl ©d' � � ev� � , '7`" ,rl e-f u �s suee�• <br />Date of staff site visit: 5� 2d % / Initials of site visit staff: <br />APPROVED BY LAND SERVICES OFFICIAL: DATE: ✓� ZI <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 />0 <br />0 <br />oc <br />5' <br />ro <br />C7 <br />o' <br />O X <br />° d <br />H <br />\v <br />z <br />Fee Re <br />: <br />4 <br />Check <br />0 <br />r� <br />a <br />z <br />0 <br />x <br />c <br />In <br />= <br />rr <br />u u' <br />�(n <br />FU <br />vo <br />C <br />CD _ <br />d <br />CD <br />jig <br />a <br />b <br />