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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 />$3001 <br />Addition/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure <br />$3001 <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 />Driveways/ & Campground Structures <br />$125 <br />Bunkhouse <br />$250 <br />WI State Statute 59.692(ly) Structures <br />$350 <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 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 />Property Site Address: (c `b30 <br />Contact's Telephone Number: Sr\r)3 <br />Contact's Email: \j ea-'�V\ €.l (G S'tCkc k,,% ct, ; fXet <br />W \ S U &'? Q, <br />City State Zip <br />-mac W 1 54 <br />Legal Description of Property: (,) % k� SE, N <br />Section #: 15 Town #: 3 3PIN Range #: K.lb 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): k k L4c� <br />Proposed Use of Structure/Addition: kowm e- <br />Anticipated Start Date: 61 ,/59 a(Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: iac i� C.tc,, r e_ Sewer Installer:�&,Ae- %yR� Ne'\k" <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT I/S SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />y <br />-711opeal "I`zle 94�ea/ <br />�T rU17e. <br />Date of staff site visit: `P Jh� Initials of site visit staff: i <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 I of 4 <br />Laserfische: - Burnett County, WI Land Use Application — Rev 1/2019 <br />ITJ <br />00 <br />5 <br />b <br />in <br />CD <br />a <br />d <br />w <br />a <br />ro <br />z <br />0 <br />z <br />c�CD Q. <br />It <br />va <br />Cn <br />r <br />b <br />Fee Rec: <br />Check #: 1441 <br />