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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 />$2S0 <br />Driveways/ & Campground Structures <br />$125 <br />WI State Statute 59.692(1v) 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: '�obr- �ALkr D <br />Prcperhy Owner°- Tea - 1 bee— IA �'lE i�U tXidlb;.t+j w 1 J`� 31•% 1 <br />&Address: <br />City State Zip <br />Property Site Address: y-ne-nAS ri1C,:&IM <br />Contact's Telephone Number: 3 Q - -709 -7 <br />Contact's Email: 1 f11Aeo 0— arc -AS n05I (_U� <br />1 D <br />? iE <br />Legal Description of Property: I--,,N k I CSrn � 2-2 T n 2 9q #3RL4 13-? 0-,o I i0A 3 ci o d <br />Section #: 7i Town #:_�N Range #:_ W Town of: SLi, .ti SS <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): '3j q <br />Proposed Use of Structure/Addition: t` t;:d4 yo ` 5kP_a9 <br />Anticipated Start Date:— 149, .� , (� (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: Sewer Installer: --�T <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />-- IUo f f z, j e U S e-<e T omnr lit U tM 4 vl GI eq !0 'I-4 -/4 d <br />�A, 5 f e-y' w� i rf' 1 S f n re / `j e. 5 7W N a 5? C,1014 Act IA f- , <br />�j i <br />Date of staff site visit: L?,& � / Initials of site visit staff: I <br />APPROVED BY LAND SERVICES OFFICIAL: DATE: Z6z/ <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 />o as <br />a <br />5' <br />0 <br />o� <br />0p <br />d <br />z <br />x <br />CJ <br />N <br />W <br />a Fee Rec: 016D00 <br />x <br />Check #: 6518 <br />