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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 />Driveways/ & Campground Structures <br />$125 <br />Bunkhouse <br />$250 <br />WI State Statute 59.692(Sv) 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, landscaoina. etc. <br />Property Owner's Name: <br />Property Owner's Mailing Address: <br />City <br />Property Site Address:,ty r-, <br />Contact's Telephone Number: '21s 3 // y - -Z 3 m 3 <br />Contact's Email: �/�%J 17 E <br />ems, <br />cc <br />Stage Zip <br />Legal Description of Property: <br />Section #:-� '41 Town #:_.)l�N Range #:/e/ 4,1 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 />P6 n <br />Tax ID # (1-5 digit number; found on tax statement):,*%' O/g-�- ' �`��'✓�`�`:3 0 /- ood o%��� <br />Proposed Use of Structure/Addition: <br />Anticipated Start Date: .1, 6 <br />(Home/Cabin, Commercial Business djoe; k; et <br />Building Contractor: � tD � � 40 -w-, 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 />I7�a�y sys , z 6edYrOI,0 54d1I�441y <br />SyS�� <br />Date of staff site visit: I Initials of site visit staff: <br />APPROVED BY LAND SERVICES OFFICIAL: DATE: -7/ / 20 <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 />L< <br />r <br />0 <br />n <br />C <br />0 <br />C7 <br />w <br />o <br />as <br />� <br />C7 <br />o � <br />� d <br />y <br />Q�, <br />d <br />z <br />z <br />y <br />Fee Rec:D <br />x <br />Check #: <br />0 <br />rfl <br />z <br />arrC <br />ri <br />�uuu <br />9999 <br />CD <br />_. <br />0 <br />