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LAND USE PERMIT APPLICATION—Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line <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 /> c� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk ✓Bunkhouse $250 '—N, <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r- <br /> A <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after cons ruction has begun)may cost up to three timesthe normal fee. ./ <br /> *Communication Towers&Signs require a differenr application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structu res,such as:pergolas,landscaping,etc. C <br /> z Q/ <br /> �AvL-� D/>f 55-q p-c-ft Property Owner's Name: <br /> 0 <br /> Property Owner's Mailing Address: f ) a ot 0 <br /> rty State Zip R. <br /> Property Site Address: - � A o a N d/ t 4 Z Ad / 111c& C <br /> o <br /> Contact's Telephone Number: 12 ! -7 �" i-1 .aLta <br /> 0 <br /> Contact's Email: 0-2� aVN 0 0 <br /> Legal Description of Property: L u C"T 6 O ' N G z-y(,,jZ;V N1 c n f L 7 n4 <br /> Section#: � Town#: 3 -7 N Range#: W Town of:-TR NDE LA-le- 6� ro <br /> d <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* R <br /> o' <br /> Tax ID#(1-5 digit number; found on tax statement): <br /> Proposed Use of Structure/Addition: N�'��S �o Q ��— P ► y <br /> Anticipated Start Date: M%D Jy N E 3 o f el (Homel'Cahin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor:00ir N g NWD`(' C*f''t%?—'%2Pt41D Sewer Installer: N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITI NS LISTED B LOW: <br /> U UAN � �ki v V�1 <br /> y <br /> y `�O Fee Re� J�O <br /> x <br /> Check#: P' <br /> Date of staff site visit: � t Initials of site visit staff: r <br /> p J c <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: a Z� r <br /> UPON APPROVAL: APP ICANT MUST POST COPY OF z CSC <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT $ <br /> Transcendent: - CM <br /> Page I of 4 <br /> mLaserfische: Burnett County,WI Land Use Application—Rev 1/2019 <br /> d <br /> a <br /> -o <br />