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LAND USE PERMIT APPLICATION - Burnett County, WI b <br /> Applicant Complete All Sections Below This Line <br /> CD <br /> Permit Types and Fees:(Please,check appropriate boxes) Qd d <br /> Dwelling/Principal Structure T$125 <br /> Addition/Alteration to Dwelling/Principal Structure <br /> Commercial/Industrial Structure Addition/Alteration to Commercial/Industrial Structure $200 <br /> f <br /> Accessory Structure(Garage,Shed,etc.) Addition/Alteration to Accessory Structure $150 CD <br /> Accessory Structure(Commercial/Industrial) Addition/Alteration to Bunkhouse $150 " <br /> G� <br /> Deck/Stairs/Patio/Retaining Wall/SidewalkBunkhouse $250 ° c� <br /> Driveways/&Campground Structures WI State Statute 59.692(ly)Structures $350 c- a <br /> o (� <br /> Filling/Grading $150 Boathouse $500 \-�- <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(lYear Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit a uired after construction has begun)may cost up to three times the n�fee. <br /> *Communication Towers&Signs require a different application form,see corresponding application,a <br /> CD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r. <br /> 0 <br /> oc--- <br /> Property Owner's Name:��,,} y� (e--(( � (� <br /> Property Owner's Mailing Address: r ( '1 � <br /> City ttate Zip <br /> Property Site Address:1 o P58(e C)f I( (--c i tJ e 11 wCc, , U--r .SyL, �) <br /> o � <br /> Contact's Telephone Number: 7�?/ <br /> d <br /> Contact's Email: ' <br /> Legal Description of Property: ao <br /> Section#:_r.�Town#: N Range#:_jj�p W Town of. &C (c.-w-N <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): -I�7 (;6ct tvcAl c ++c.G(tle.(, El, <br /> 7 <br /> Proposed Use of Structure/Addition: k r fl k <br /> Anticipated Start Date: & ` L12 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ° C7 <br /> Building Contractor: t s + e. Sewer Installer: i�-1-! r t <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY II�` <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> z <br /> = Fee Rec��'D <br /> /C/%� Check#: I3<<T <br /> o <br /> Date of staff site visit: P?,0 <br /> Initi of site visit staff: M <br /> APPROVED BY LAND SERVICES OFFICI C DATE: <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> a �mC7 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Transcendent: - Page 1 of 4 � o <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 <br /> r< <br /> o <br /> CD <br /> b <br />