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LAND USE PERMIT APPLICATION- Burnett County, WI <br /> a <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) d Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 �� O <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 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> r � <br /> 710 <br /> Filling/Grading $150 Boathouse $500 ° � <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 w <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 will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> z <br /> Property Owner's Name: X,,5_5e,// lt/ i/��,�� ,� ° <br /> Property Owner's Mailing Address: fi-k �j 4AA,1 tr 1- 4,r '! d <br /> City State Zip P <br /> Property Site Address: 2 ,7q 3 a A- A4,; <br /> C. <br /> Contact's Telephone Number: i�'- <br /> d <br /> Contact's Email: <br /> Legal Description of Property: o <br /> Section#: Town#: G � N Range#: J` W Town of: .�11C lip� a iri GQ <br /> ti <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): -Sf o <br /> Proposed Use of Structure/Addition: 0 4"-I't <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) d <br /> Building Contractor: S�r�' Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY n �Q <br /> THIS PERTMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: ] <br /> o <br /> Fee Rec: � <br /> Check#: tw <br /> Date of staff site visit: {{ Initials of site visit staff: <br /> o 0 <br /> APPROVED BY LAND SERVICES OFFIV!��!�DATE3__50r—�" m <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 'rn <br /> SIGNED PERMIT APPLICATIONm :.IN PLAIN SIGHT o <br /> Transcendent: - a fi CD <br /> Page 1 of 4 <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 C <br />