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LAND USE PERMIT APPLICATION—Burnett County, WI b <br /> Applicant Complete All Sections Below This Line o <br /> C <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure ]1200 <br /> Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure Addition/Alteration to Commercial/Industrial Structure $200 �J <br /> Accessory Structure(Garage,Shed,etc.) Addition/Alteration to Accessory Structure $150 <br /> AccessoryStructure Commercial Industrial <br /> ( / ) Addition/Alteration to Bunkhouse $150 � 1SDeck/Stairs/Patio/RetainingWall/SidewalkBunkhouse $250 <br /> Driveways/&Campground Structures WI State Statute 59.692(ly)Structures $350Filling/Grading Boathouse °$500Six Month Camping Unit(One Per Year) Permit Extension(lYearExtension-Allowed Once) $100 <br /> *NOTE:After-the-fad 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 not listed above will be tre9ted as accessory structures,such as:pergolas,landscaping,etc. r, Q <br /> � z <br /> Property Owner's Name: ffe� ' ° <br /> Property Owner's Mailing Address: <br /> City State Zip <br /> Property Site Address: �� e <br /> f < <br /> Contact's Telephone Number: �d <br /> d <br /> Contact's Email: oIV <br /> Legal Description of Property: <br /> / o <br /> Section#:, ,�Town#: N Range W Town of: 5(01JS a� <br /> *Attach additionalpage if neededfor 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): r'�/1.20T <br /> o <br /> Proposed Use of Structure/Addition: STTRAG'F <br /> Anticipated Start Date: 4)bw (Home/Cabin:Commercial Business;Bedroom;Deck:etc) <br /> Building Contractor: Sewer Installer: � R <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF CONINIENTS/CONDITIONS ONLY fti <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> z <br /> z <br /> -j Fee Rec: -7§15V <br /> Check#: 3*/7 <br /> 92 <br /> Date of staff site visit; X-- Init' 1 of site visit staff: / .o 1— <br /> APPROVED BY LAND SERVICES OFFICIA I E; Id— y <br /> m <br /> ri <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF y .T ` <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> - -- <br /> Transcendent: <br /> Page 1 of 4 m <br /> Laserfische: - Burnett County,WI Land Use Application —Rev 1/2019 <br /> m <br /> a <br /> -o <br />