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CD <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> CD <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $-ZQO _ �? <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 Q <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 /> C] <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 r- <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> 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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r. <br /> 0 <br /> nn p z <br /> J <br /> Property Owner's Name: Q C 4 h ° <br /> Property Owner's Mailing Address: 8/� /��e ,���✓ �d �^�C�t �� s��9� <br /> City State Zip rn„ <br /> Property Site Address: <br /> o N <br /> Contact's Telephone Number: a <br /> d <br /> Contact's Email: <br /> Legal Description of Property: <br /> Section#: z 7 Town#: 3 7 N Range#: 4G W Town of: <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): Z <br /> Proposed Use of Structure/Addition: s� wee n Qeyr'G1 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business:Bedroom;Deck;etc.) � C7 <br /> Building Contractor: Sewer Installer: H �! <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> — n,I' Pee AA)f rS -( /e sc-rc.etl p pec 731 1'�KfC- ql�wellll , W/ z s° N <br /> U9aS GoxS7�Yuc�c b�7�wee� Z0/3 ©WmceC of )1, 7- <br /> G�oGfz/e�. <br /> ,r,ec,� P e rlk.., �/ <br /> -- 'C if�P� /5 X?' e,, , 7liian /00 Sq 1 l� !aJ/// r1eC°Q G /G1��USe �j�unljL R3( i <br /> loy 1 Zl t l zo!9, / / / / L / r / / Fee Rec. <br /> f�A�e S ui^G �D�t� 4rl d �A'llil /S mjt P�ctG�t S'c�77G %c7�1/� !/�S Check#: <br /> T o <br /> Date of staff site visit: �0�3�/ Initials of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICIAL: ATE: <br /> UPON APPROVAL: APP , ICANT MUST POST COPY OF <br /> m <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 95 <br /> o <br /> Transcendent: _ Page 1 of 4 c Q <br /> Laserfische: _ Burnett County, WI Land Use Application—Rev 1/2019 ---=�jll( <br /> a <br /> b <br />