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h � <br /> LAND USE PERMIT APPLICATION - Burnett County, WI a 9 b <br /> y 1 <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 $150CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 R <br /> o <br /> XDeck/Stairs/Patio/Retaining Wall/Sidewalk 113unkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 r <br /> Fillip 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 /> o <br /> z <br /> Property Owner's Name: ir-r t I slot ,O I c C ° <br /> m <br /> 0 <br /> Property Owner's Mailing Address: ,-; - 41ehsle, <br /> City State Zip <br /> Property Site Address:j"In , <br /> Contact's Telephone Number: C JT ,f 7 <br /> C7 <br /> Contact's Email: c o: <br /> Legal Description of Property: �'p G r f— b / r o w <br /> Section#: Town#: N Range#: / 'W —Town of. o <br /> t7 <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): ( <br /> Proposed Use of Structure/Addition: '( x <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) C7 <br /> Building Contractor: P.-tf-S. 5' �e p Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLYj� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> z <br /> x Fee Rec:1254 <br /> 7, Check#: _ <br /> Date of staff site visit: I 'tials of site visit staff: <br /> z c APPROVED BY LAND SERVICES OFFICI DATE: UU <br /> UPON APPROVAL: APPLICANT MUST POST a COPY m <br /> O OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o y <br /> r, 00 <br /> Transcendent: - Page 1 of 4 C <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 Gl <br /> a <br />