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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> Applicant Complete All Sections Below This Line s <br /> n. <br /> Permit Types and Fees:(Please,check appropriate boxes) j w� <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 1 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 �O <br /> 77 Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 CD <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 WI State Statute 59.692(ly)Structures $350 r <br /> Filling/Grng $150 adi Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 C' <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 <br /> treated as accessory structures,such as:pergolas,landscaping,etc. r. Ei (° <br /> Property Owner's Name: v <br /> Property Owner's Mailing Address: &I oo 7 - 7 Jtl-e 4/10 1 f✓ _ kz— S <br /> L! [ City State Zip <br /> Property Site Address: 7 S-1 ��0= �'G( ✓G fr�c .� ,'��T 30 <br /> Contact's Telephone Number: 77 15 ` �760 P3 O a <br /> d <br /> Contact's Email: Q 1'eq C010) <br /> Legal Description of Property: d b+ L(I b+ f: L-04 6 /,5X l 7 o� <br /> Section#: Town#: /— N Range#:_ W Town of. A,34 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 /> Tax ID#(1-5 digit number; found on tax/statement):VS- 3 V <br /> Cn <br /> Proposed Use of Structure/Additio _ (%? _ � S e <br /> Anticipated Start Date: o l-� (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ° C7 <br /> Building Contractor:, ruC to re jj��� t�J L �iYl>r�„S� Sewer Installer: /V q / d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMiVIENTS/CONDITIONS ONLY U\ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> -JFb( LIX z <br /> Fee Rec:� � <br /> Check#: <br /> O / t / � L� CAS <br /> Date of staff site visit: Initials si a visit staff: a <br /> z <br /> C <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF u, <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT -° <br /> o� <br /> Transcendent: - Page 1 of 4 o <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 C <br />