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LAND USE PERMIT APPLICATION - Burnett County, WI r <br /> En <br /> Applicant Complete All Sections Below This Line <br /> m <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $3 Addition/Alteration to Commercial/Industrial Structure $200 `J <br /> Accessory Structure(Garage,Shed,etc.) $15 Addition/Alteration to Accessory Structure $150 R <br /> Accessory Structure(Commercial/Industrial) $2 00 Addition/Alteration to Bunkhouse $150 4z <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> r <br /> Filling/Grading $150 Boathouse <br /> $500 � <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. w <br /> A <br /> *Communication Towers&Signs require a different application form,see corresponding application,and fees. �1 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. C. <br /> 0 <br /> z Property Owner's Name: RA ����i ^ �11� � ° < <br /> Property Owner's Mailing Address: 3 ►1 SS C i�, <br /> City State Zip <br /> Property Site Address: <br /> Contact's Telephone Number: b) �. �, �y � o a <br /> Contact's Email: <br /> \\ V t C <br /> Legal Description of Property: �1 �ss <br /> Section Town#: 40 N Range#:__L3 W Town of: \X�'� E. o <br /> e <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tac system property page. <br /> o' <br /> Tax ID#(1-5 digit number; found on tax statement): J-�C7 -�C <br /> Proposed Use of Structure/Addition: cZck`(te,� o x <br /> Anticipated Start Date: V (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) C7 <br /> Building Contractor:��, Sewer Installer: <br /> N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED/ BELOW: <br /> J'✓!u ke 5 ti vie 7to w►,c,e,7 /U f'f f t 71 ►t/� f v s I'q=t, �o YL li i�e, z <br /> -- �''�ak e S u t�2 7'� r►1�c,�f l� � S ef�ocr� � �i e. �e. o� <br /> -ff,e- tin o u <br /> Lv <br /> � T Fee Rec: <br /> 4v'oc1, r1��' 7/V 2r -faP- flu ,,s.0 �oA %Q17d014 Check#: <br /> r � o <br /> Date of staff site visit: 7 I 7 / Initials of site visit staff: 7i a <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 7 O <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> Q C <br /> r <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTNj <br /> -- <br /> Transcendent: - Page 1 of 4 ' o <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 <br />