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10 <br /> LAND USE PERMIT APPLICATION— Burnett County, WI & <br /> n <br /> C. L� <br /> G <br /> Applicant Complete All Sections Below This Line <br /> a <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 g <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 M C <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 C- <br /> 0 <br /> Filling/Grading $150 Boathouse $5W <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year 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 /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: J 1 QZ1 -k<, 6- <br /> Property Owner's Mailing Address: 2 �ylo ' Ve_ e r,/,ft <br /> City State Zip <br /> Property Site Address: s'�2(� ^41go e- or- <br /> Contact's Telephone Number: 76 3 `i`7 I- i` O o <br /> Q _a <br /> O <br /> Contact's Email: Le I 1/W j"'I'o i+� �(�l� (9z inr:i Co/n Legal Description of Property: /`e v i tL.J 4 e►1�s 7 446? el k i a <br /> Section#: 3C7 Town#:��N Range#J�7 Town of: un <br /> *Attach additionalpage 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): 915- i/ <br /> o w <br /> Proposed Use of Structure/Addition: SC_Me,7 PVrC <br /> Anticipated Start Date: /D 1152 (Home/Cabin;Commercial Business;Bedroom;Deck;etc) C7 <br /> Building Contractor: -se_f F Sewer Installer: N <br /> C3� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> z <br /> sago a <br /> a <br /> Fee Rec: <br /> lo�a/o��� Check#: 51 DO <br /> d <br /> Date of staff site visit: Initials of site visit staff: <br /> l <br /> APPROVED BY LAND SERVICES OFFICIAL <br /> U�U <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF C W M <br /> <.3 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> 00 <br /> 0 <br /> Transcendent: - K cm Page 1 of 4 c� <br /> c� <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019CD <br /> CD <br />