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LAND USE PERMIT APPLICATION -Burnett County, WI b <br /> Applicant Complete All Sections Below This Line �o <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 $300 Addition/Alteration to Commercial/Industrial Structure $200 <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 /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r- <br /> Filling/Grading $150 Boathouse $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. <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. r <br /> 0 <br /> z <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: 1 lib E251 I<9 <br /> City 0 State Zip <br /> Property Site Address: hug Pk b itn '-Rd <br /> � J-)C�nt»7g-r ,, t y: � <br /> Contact's Telephone Number:�"7 <br /> d <br /> Contact's Email: (�Q�j ��' j�Y't Y C i �}�Q J 0 m <br /> Legal Description of Property: IZ+ I in 7 14,- P t 2 5 6!^A✓ [nT 64 7) 0 uo <br /> Section#: Town#:--4C� N Range#: W Town of. �j(1�`f �- <br /> C7 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> o' <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> o <br /> Proposed Use of Structure/Addition: � <br /> Anticipated Start Date: 9,-`'�--l!j (Home/Cabin;Commercial Business;Bedroom;Deck;etc) C7 <br /> Building Contractor:Q-64�1 "rA r-,eA t an, 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 /> z <br /> z <br /> y Fee Rec <br /> x <br /> // Check <br /> �6 d <br /> Date of staff site visit: "initials�of site visit staff: r <br /> a <br /> APPROVED BY LAND SERVICES OFFICIAL: �Or�DATE: <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Transcendent: - Page 1 of 4 �' '� 9H <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 o <br /> b �y <br />