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LAND USE PERMIT APPLICATION—Burnett County, WI ^_ " ` <br /> c � <br /> < b <br /> Applicant Complete All Sections Below This Line ? c <br /> )ermitTypes and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 a <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> r <br /> Filling Grading $150 113oathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 1 1 Permit Extension(1 Year Extension-Allowed Once) $100 [A <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. n ^ <br /> `Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 1 <br /> roperty Owner's Name: 15 G ° — <br /> �7— <br /> roperty Owner's Mailing Address: 54%q_3City <br /> roperty Site Address:71 0 1 614k_-) Ek m6s4e t- IVT ! V 3 State Zip <br /> ontact's Telephone Number:��O�� l Q- Gl�7`' ° Q <br /> `f d <br /> ontact's Email: <br /> egal Description of Property: 3G X Fa 41 le SyeC, <br /> ection#: Town#: N Range#: W Town of: lia K knA o <br /> 0 <br /> 4itach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.' <br /> ii <br /> ax ID#(1-5 digit number;found on tax statement): q <br /> I LI r„ <br /> S1 <br /> roposed Use of Structure/Addition: nec� /SA-L l 1 C cq cL o <br /> � E <br /> .nticipated Start Date: ' rx-t j (HomelC in;Commercial Business;Bedroom;Deck;etc.) <br /> uilding Contractor: ��`111(�l1 Sewer installer: A `A <br /> .REA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: N ;A <br /> �k_0 X <br /> Fee Rec:� <br /> J� N Check#: 3 <br /> ate of staff site visit:7 ��I vljn s of site visit staff: <br /> l z <br /> .PPROVED BY LAND SERVICES OFFICI DATE: --.Z6 <br /> JPON APPROVAL: AP LICANT MUST POST COPY OF <br /> CL <br /> ;v <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT (03 F; <br /> C <br /> Transcendent: Page 1 of 4 io <br /> Laserfische: Burnett County,WI Land Use Application-Rev 1/2019 0 0 <br /> ro :: C=' <br /> 3 K cc <br /> a 3 <br /> CD <br /> Quick Notes Page 2 <br />