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LAND USE PERNUT APPLICATION—Burnett County, WI kn ro t~ <br /> Cr � b <br /> \ JPermit Types and Fees:(Weose;cbecic appropriate boxes)° m <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 Commercial/industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 Y <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures I$135 jWl State Statute S9.692(iv)Structures $3S0 k. <br /> Filling/Grading $1% Boathouse $500 <br /> 0 <br /> Six Wnth Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 m <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 oppGavtion form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structure!;,such as:pergolas,landscaping,etc S <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: q3q e �/`� w <br /> a � n �, city star zip a <br /> Property Site Address: �-{81Jlse % t� <br /> Contact's Telephone Number. b J g- y 7 7 _ a <br /> v <br /> Contact's Email: M0-V°- 5 o J 0� G -CA iic • com <br /> Legal Description of Property: Oda '(� c <br /> Section#:_ P-1 Town# N Range#:_ _W Town of: �m�{ 0 <br /> "Attach additional page if needed for lengthy description OR attach a cope,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/Additi n: Co (/� �+'0 Cs _, y x <br /> o <br /> Anticipated Start Date:pa ( 1161 (Home/Cahn,Comrnerciat Buci»essnB'edi»orn:heck;etc.) C7 <br /> Building Contractor. Sewer Installer /UQ n e, W <br /> AA*k *T!x1sLDM- srA 1j r4Frl1V. i-ilizrr ONS ONL <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> t/, C4 LN C4 d4-g--5 to 1,#4 1 ti <br /> 5 <br /> Fee Rec:wi ' <br /> Check#: q <br /> Date of staff site visit: ft ` o2o site visit staff: \ ;a <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> grl <br /> L A'I' aN IN PLAIN U G� <br /> o r� <br /> Transcendent: - Pagel Of 4 <br /> Lase6sche: - Burnett County,W l Land U*e Application-Rev 1/2019 <br />