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� LAND USE PERMIT APPLICATION - Burnett County, WI <br /> — i <br /> Applicant Complete All Sections Belovv fhis Line <br /> n. <br /> Permit Types and Fees:(Please,check appropriate boxes) - ,J <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,Sped,etc.) $1.50 Addition/Alteration to Accessory Structure $1.i0 <br /> Accessory Structure(Commercial/Inc;,strial) $200 Adr,'ition/Alteration tc)Bunkhouse <br /> Deck/Stairs/Patio/Retaining Wail/Sidewalk Bunkhouse 21i0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1y)Structures $3`i0 <br /> Filling/Grading $1s0 Boathouse $500 <br /> Six Month Cramping Unit(One Per Year) $1.00 Permit Extension(1.Year Extension-Allowed Once) $1.00 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun) may cost up to three times the normal fee. <br /> *Communication lowers&.Signs require a different application form;.see corresponding opplicotioo,ondlees. <br /> *Items not listed above will be treated as accessory.structures,such as.pergolas,landscaping,etc. <br /> Z. <br /> Property Owner's Name: _ �� Q m•�4t(-4 - 45044-0 c <br /> Property Owner's Mailing Address: '2 �I <br /> n _City Sttt'c %i;_<972 n <br /> Property Site Address: .2-r -aq poic,`," Qt� • S��or W.� rerry� S <br /> Contact's Telephone Number: <br /> Contact's I?maiL OKZO s� - -�{ •*�.�. ne- <br /> Legal Description of Property: no <br /> Section tl: 3 ( \ Rangc t�: /Y W l osrn of': RLis pro <br /> *Vlach additional page it needc rl/or lecl"thl descriplion OR(mach a cope of the deed OR attach lav.cvsicm properh page. <br /> Fax ID It 1-5 digit number; found on tax statement): <br /> Prop <br /> Proposed tJse of Structure/Addition: <br /> Anticipated Start Date: ?I z-7�(� 'llr,mr Cabin C,omnten wl Bcr mess Bed"rooly Ucck:cif � <br /> I3uilding Contractor: %0 'Gl� Sesser Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMI"I' IS SUBJF.C'I' TO ALL CONDITIONS LISTED BELOW: <br /> fit- t3o ekck vKtts f lot Suva- let Fof <br /> -,bl ' <br /> Fee Rec-30— <br /> s �` <br /> Check fl: 3253 <br /> Date of staffsite isit: /aa <br /> � Initials of site visit staff: <br /> z <br /> APPROVED BY LAND SERVICES OFFICIAL. ���lt__- DATE: _ <br /> UPON APPROVAL: APP CAN ST POST C PY OF a G <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> C)° C <br /> ITranscendent: °Page I ol'4 0 C ra �' <br /> .0 o <br /> Laserfische: - Burnett County, WI Land Use Application — Rev 1/2019 � <br /> - - - � Il! <br /> o � <br />