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LAND USE PERMIT APPLICATION —Burnett County, WI a <br /> Applicant Complete All Sections Below This Line <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(Commercal/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> xDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> l � <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. S <br /> , r i� o <br /> Property Owner's Name: O C:XI ti11 5 '»0-(1.S en <br /> o <br /> Property Owner's Mailing Address: Z 0 Z 1 LA l lC_k— 1A).L 15 <br /> City State Zip 5 <br /> Property Site Address: (62-6 Fj PL VGt_11SkX I <br /> Contact's Telephone Number: <br /> Contact's Email: A obn V (6- 1clk-,e lan1 - LiL <br /> Legal Description of Property: PCL 5t12 bi/Z 5i -) 5L 5E <br /> Section#: _ToNvn##: -_-�9 N Range#: ( W Town of: me-q-r o i'�, <br /> *,attach additional page if needed for lengthy description OR attach a copy of the deed OR attach far system properjy page. <br /> Tax fD#(1-5 digit number;found on tax statement): t 2s <br /> I � <br /> Proposed Use of Structure!Addition: Px1jc L Q-Q-GK ° x <br /> Anticipated Stair Date: 1 O f i /LO k Q ( atne eabin:C ommerciat Business:Bedroom,IJeck:etc.) j <br /> I <br /> Building Contractor: 5e-I Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY j ; 1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: i <br /> ro ri- - QkC' �p z <br /> c <br /> Fee Rec:f�'� L.� <br /> 68 Check#: <br /> Date of staff site viszt � ° iti of site visit staff: <br /> APPROVED BY LAi�ID SERVICES OFFI r°' <br /> :4 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF r C� <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> X <br /> Transcendent: - Page 1 of 4 ' <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 � <br />