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LAND USE PERMIT APPLICATION—Burnett County, WI g <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 /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o <br /> < CIO <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(lv)Structures $350 C. <br /> Filling/Grading $150 lBoathouse $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. ro <br /> *Items not listed above wilibe treated as accessory structures,such as:pergolas,landscaping,etc. t, <br /> 0 <br /> Property Owner's Name: ,,A AA y �LL ° <br /> _gµ L'C bH.L N ,TI <br /> O <br /> Property Owner's Mailing Address: l`I3a wK be. NE F s M S' o �a <br /> City State Zip (� <br /> Property Site Address: 1 1 01 1 7 �S e R. G r a �1%6 .r a W L S y <br /> C <br /> Contact's Telephone Number: 5-5 g - a,,9 If 17 o _a <br /> Contact's Email: <br /> Legal Description of Property: FfZ N W /V¢ t:x All RQ i, W aD R to 00 <br /> Section#: Oq Town#:__37_N Range#:_A_%_W Town of: 'rrQ g <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): 3 a 3 d <br /> Proposed Use of Structure/Addition: BuAK hease- <br /> Anticipated Start Date: 9-1-Iq (Home/Cabin;Commercial Business;Bedroom;Deck;etc) <br /> Building Contractor: .S*-1 P. Sewer Installer: Wa d e- 'RJ_S 10(to a <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Cat <br /> z d <br /> z <br /> Fee Rec: <br /> C� <br /> o Check#: 13,)2G, <br /> Date of staff site visit: t l t iti is of site visit staff: �� r <br /> / a <br /> -DATE.-APPROVED BY LAND SERVICES OFF E: 9—!D <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 00 <br /> Transcendent: - Page 1 of 4AD <br /> Laserfische: Burnett County,WI Land Use Application—Rev 1/2019 <br /> a <br />