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LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line <br /> d �4— <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 p� <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 C; <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° ro <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(iv)Structures $350 �- < <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 1permit Extension(1 Year Extension-Allowed On $100 <br /> 0 <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. 0 9 <br /> 1 <br /> z <br /> Property Owner's Name: <br /> J °o <br /> Property Owner's Mailing Address: ir u►11� �6 <br /> City State Zip <br /> Property Site Address: 2-8 17'q Sorb pR,. GA_v,6,>r, 3 14 e3D <br /> Contact's Telephone Number: . g —3 4q <br /> Contact's Email: a r <br /> Legal Description of Property: l iv T V <br /> Section Town#: I.Lo N Range#: 17 W Town of: t)n o t1 x <br /> d <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): 1 t) D lz� <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: q (Home Cabi Commercial Business;Bedroom;Deck;etc.) p <br /> Building Contractor: Sewer Installer: �pkins <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BE OW: G p <br /> ��ve � z c1� <br /> Cslt' - <br /> Fee Rec: - <br /> Check <br /> Date of staff site visit. j itials of site visit staff. <br /> a <br /> z <br /> _ o <br /> APPROVED BY LAND SERVICES OFFI ~ DATE? <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTB --% I <br /> o <br /> Transcendent: - cn <br /> Page 1 of 4 <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 <br /> 0 <br /> a <br />