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LAND USE PERMIT APPLICATION—Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line c o <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) d qz> <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 \ -- <br /> Driveways/&Campground Structures $125 IWI State Statute 59.692(ly)Structures $350 r. <br /> Filling/Grading $150 lBoathouse $500 0 <br /> Six Month Camping Unit(One Per Year) $100 113ermit Extension(lYear 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. <br /> CD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r . <br /> o 0 <br /> Property Owner's Name:r>i l —I- o yy'%C )�yn e us- <br /> Property Owner's Mailing Address: -7 6:l k-614 <br /> City State Zi <br /> Property Site Address: 6>q775, U15�1 "t (�� j V1 <br /> Contact's Telephone Number: 77 — 77 <br /> Oa <br /> Contact's Email: �/ L W—S <br /> Legal Description of Property: 177 QSM' V W [Wit]^ )' oN <br /> 2. <br /> Section#: ( _Town#:_YQW N Range#:/4, W Town of- C&4C 6 <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 /> o' <br /> Tax ID#(1-5 digit number;found on tax statement): �� r„ <br /> y <br /> Proposed Use of Structure/Addition: / �o P <br /> Anticipated Start Date: (Home/Cabin;Commercial Business,Bedroom;Deck;etc.) d <br /> Building Contractor: Ajtq- W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CON,NDITIONS LI ED ELOW: <br /> Fee Rec: <br /> Check#: <br /> Date of staff site visit: In' ' of site visit staff: a <br /> z <br /> _ o <br /> APPROVED BY LAND SERVICES OFFICIA : DATE: <br /> c <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 z a (? <br /> Transcendent: - Page 1 of 4 g <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 < s�z ccc <br /> d � <br /> r� <br />