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LAND USE PERMIT APPLICATION —Burnett County, WI g <br /> Applicant Complete All Sections Below This Line <br /> P cis <br /> Permit Types and Fees:(Please,check appropriate boxes) O �\ <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 Q 0 <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 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 /> *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 /> z <br /> Property Owner's Name:ERIC KSON FAmdq TN UF'SrMenTS L LC ° <br /> Property Owner's Mailing Address: 8ax 61AIe e ((J1• 51�39 <br /> City State Zip <br /> Property Site Address:253Ala 5T Rd 3 51 LoeBMr eI UJ1,516593 <br /> o <br /> Contact's Telephone Number: !r/15• 7 81-©Q 744 <br /> Contact's Email: <br /> Legal Description of Property:C5 M *14 3 4 2- V-2 3 P 234 ( 4 4 04 6212) LOT <br /> Section#: 28 Town#:39 tL N Range#:116\&jW Town of.rnC e o o f) <br /> 0 <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): <br /> Proposed Use of Structure/Addition: E O ' <br /> Anticipated Start Date: (Home/Cabin;Commercial Business:Bedroom:Deck;etc) C7 <br /> Building Contractor: BRAD S Q A FFO RD Sewer Installer:e F? <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: N <br /> r� <br /> x Fee Rec. � <br /> I Check#: I <br /> Date of staff site visi� t O I Walls of site visit staff: Vkx� r,/ pq <br /> APPROVED BY LAND SERVICES OFFICIA�V­C�� DATE: (Ort'f'9-off( 1 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF m <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 <br /> Transcendent: - Page 1 of 4 <br /> 3 <br /> Laserfische: - Burnett County,WI Land Use Application-Rev 1/2019 <br /> 3 <br />