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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line CD � <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 CO <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 CD <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 C• <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension( ear Extension Allowed Once) $100 P <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 /> y G p I , z <br /> Property Owner's Name: - ( fyi e-f- <br /> � <br /> Property Owner's Mailing Address: I q q 0 V ✓1 f1 1OaakLry tip L3C <br /> City State Zip <br /> Property Site Address: 1 q7 flV n)q Oayl 19 <br /> o � <br /> Contact's Telephone Number: <br /> d <br /> Contact's Email: <br /> Legal Description of Property: Ye l to w L g l(e' a Inm on t� N � <br /> Section#: d-0_Town#: G N Range#: )6 VI/ W Town of:Oct k Lgild c,wn ghi� <br /> *Attach additionalpage if neededfor lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br /> Tax ID#(1-5 digit number;found on tax statement): Ff 145. <br /> 'I'c� <br /> Proposed Use of Structure/Addition: -to rot toe- �d 0 x <br /> Anticipated Start Date:y-� (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) t7 <br /> Building Contractor:Prey fat^/lr bl e 0 O a 1 d jM 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 /> Mist hod be- w6ed 4y- hwtt,at4 hafolf�11oq <br /> Fee Rec: <br /> Check#: <br /> Q i? <br /> Date of staff site visit: g 15A-P 1 I Initials of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICIAL• DATE: I z r; <br /> UPON APPROVAL: APPLICAN UST POST O Y OF a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT N <br /> N C= <br /> O 00 <br /> 0 ca> <br /> Transcendent: - Page 1 of 4 :�� Co <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 <br /> o <br /> a <br /> b <br />