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LAND USE PERMIT APPLICATION—Burnett County, WI <br /> Applicant Complete All Sections Below This Line <br /> a � <br /> A <br /> Permit Types and Fees:(Please,check appropriate boxes) d <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 /> / 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(I 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. ro <br /> *Items nothsted above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- <br /> 0 <br /> (� z <br /> Property Owner's Name: `l1 r l 1 '' { y <br /> Property Owner's Mailing Address: lJ S L <br /> City State Zip <br /> Property Site Address: �� �'� C <br /> o <br /> Contact's Telephone Number: <br /> a <br /> Contact's Email: <br /> Legal Descri tion of Property: ��7 �—t0 �/� / L <br /> Section#: Town#: c N Range#:�_W Town of: `ti�e-� c�ill ro <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: <br /> f <br /> Anticipated Start Date: \t0 7 I E, (Home/Cabin;Commercial Business;Bedroom;Deck:etc) ° C7 <br /> Building Contractor: S Ql- - Sewer Installer: <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 /> s Fee Rec: <br /> Check <br /> Date of staff site visit: 1 Ini ' o it visit staff: a <br /> z <br /> lam, C <br /> APPROVED BY LAND SERVICES OF ICI DATE: �- <br /> m � <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z CD <br /> 00 <br /> Transcendent: - Page 1 of 4 m c cQ�a <br /> Laserfische: - Burnett County,WI Land Use Application —Rev 1/2019 � N� <br /> o <br /> a <br /> z <br />