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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 />X <br />Accessory Structure(tGarage, Shed', etc.) <br />$1'9 <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(iv) Structures <br />$350 <br />Driveways/ & Campground Structures <br />$125 <br />Filling/Grading <br />$1S0 <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: I' (�(,� e 1� �O f� / rTC. l l c / �l- <br />Property Owner's Mailing Address: I `� CA 6 � � � - A. C-1,I 61.1j <br />\ L) Si t 24 <br />Property Site Address: `i lCl �ij �—� I ? <br />Contact's Telephone Number: Ion - �)_A \_Q 9 C1 <br />is <br />`t" G' <br />Contact's Email: t)v�, it coykf cc�- ON E� <br />Legal Descri..r;.,,, f Property:I V 1/r L '/Z SC- J e <br />V1 <br />Section #: 3 `7 Town #: u C N Range #: W Town of: J Ck- C-ILS O f1 <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): <br />Proposed Use of Struc e/Addition• ~— <br />Anticipated Start Date: C"+��'`f't VU` one/Cab6:-Co mmercialBusiness; Bedroom; Deck; etc.) <br />LJ) PC B C = 5 i vk ui -t ;S N��4 <br />Building Contrac� w; tie - T- 13 tom, Sewer Instahher: <br />riui."" Vt lill la F"IX uL-11\1J aEMI1l,Ca a1Hri' l,y1r11r1G1\ la/1.V1,4L111ViVa V:VL1 <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Fee Rec: <br />Check #: <br />Date of staff site visit: h - ) ( 17 Initials of site visit staff: 411�• <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: /. `, , ATE: <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 8/2018 <br />