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LAND USE PERMIT APPLICATION— Burnett County, WI <br /> Applicant Complete All Sections Below This Line <br /> p d <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 I <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk nkhouse $250 <br /> Driveways/&Campground Structures $125 to Statute 59.692(ly)Structures $350 <br /> r h�L <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> f <br /> *NOTE:After-the-fact permits(permit squired after construction has begun)may cost up to three times the normal fee. � \ <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. ro <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> `� G z <br /> Property Owner's Name: D�� 1�reSC4 ° <br /> 1 � � <br /> Property Owner's Mailing Address: `[ U ® o 03 n <br /> Lu�-u 1A)0e4 ity State Zi <br /> Property Site Address: 3 <br /> Contact's Telephone Number: <br /> Contact's Email: n ejS � , ,>f� � `� 1 �'✓� <br /> II __ LLDT pp <br /> Legal Description of Property: S C$ �43 � y,/ <br /> P7g o(.0 �? <br /> Section#: Town#: Sj N Range#: W Town of: 01 <br /> . C <br /> *Attach additional page if needed for lengthy description OR attacl o of the OR attach taxes}stem pro page. <br /> Tax ID#(1-5 digit number;found on tax statement): �t? ! <br /> Proposed Use of Structure/Addition: o <br /> Anticipated Start Date: (pl wt; <br /> me/Cabin;Commercial Business; (cn✓t ZBuilding Contractor: G(JC� Sewer Installer: <br /> Vl <br /> AREA BELOW THIS LINE FOR LAND SERVICES S AFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> bQ <br /> Fee Rec: <br /> Check#: <br /> o ^ <br /> Date of staff site visit: I ' i s of site visit staff: <br /> a <br /> z <br /> APPROVED BY LAND SERVICES OFFIC DAT : <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> 0 <br /> Transcendent: . - Page 1 of 4 <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 ' <br />