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LAND USE PERMIT APPLICATION - Burnett County, WI r <br /> Applicant Complete All Sections Below This Line o <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes)IL wU <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> 1 0 <br /> 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 /> o <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/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. C- " <br /> Property Owner's Name: <br /> , 1 C, <br /> Property Owner's Mailing Address: 7 JC Hi L�,0 to r ��j IttJ "o <br /> City State Zi <br /> Property Site Address: ?/ 749 t -35 aU�it, �—��;,�� C. e/.%' ,36 � <br /> Contact's Telephone Number:�6'51 3 3 a f ? 3:;� (a Cam= <br /> o <br /> Contact's Email: ��V K O�� A fk -�- t�l,`t r"Y <br /> 0-c- K-. 5 S <br /> Legal Description of Property: o <br /> Section#: Town N Range#: L5j� W Town of: o� <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): a OZ9 02. <br /> Proposed Use of Structure/Addition: Home � f <br /> Q � x <br /> Anticipated Start Date: e/0� (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) (j o C7 <br /> Building Contractor: {_: (:` Sewer Installer: r A SX.3311 i v <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> G►i �_' .— <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> • S�rc-lc-- r�� e b b-e- F-e rr.We 4 ots rjXte_d <br /> a qveAncer� �Az Q- C� <br /> s Fee Rec:3-dw— t <br /> Check#: 9-7 � <br /> Date of staff site visit �/"G� ,Initials of site visit staff: a <br /> APPROVED BY LAND SERVICES OFFIC AL: DATE: <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF CS7? <br /> > �. <br /> Y o W —+ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o y o <br /> z c' <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 <br /> o <br /> y <br /> a <br /> b <br />