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LAND USE PERMIT APPLICATION—Burnett County, WI [ <br /> < b <br /> Applicant Complete All Sections Below This Line <br /> CD <br /> Permit Typesand Fees:(Please,please check a t7 <br /> ppropriate boxes) <br /> m <br /> Dwelling/Principal Structure $300rAddition/Alteration <br /> on/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300on/Alteration to Commercial/Industrial Structure $200 0 <br /> Accessory Structure(Garage,Shed,etc.) $150on/Alteration to Accessory Structure $150 CD <br /> Accessory Structure(Commercial/Industrial) $200n to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk ouse $250 0 <br /> Driveways/&Campground Structures $125te Statute 59.692(ly)Structures $350Filling/Grading $150ouse $500 <br /> Six Month Camping Unit(One Per Year) $100t 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. <br /> CD <br /> *Items not listed above willbe treated as accessory structures,such as:pergolas,landscaping,etc. r. <br /> o z Property Owner's Name: <br /> Property Owner's Mailing Address: � 7 c7 /16-Av /Zj <br /> City State Zip = U <br /> Property Site Address: Z�p 6*� 3 ll:�,�o <br /> Contact's Telephone Number: <br /> Contact's Email: <br /> � p <br /> Legal Description of Property: Li' � / Cam 4�1 b' y / l 9 0 <br /> Section#: 4 Town#: yG' N Range#: l W Town of. e;rA� k /,-,"i- <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: <br /> F <br /> Anticipated Start Date:D,/! !d`Z1213 (Home/Cabin:Commercial Business;Bedroom:Deck;etc) ^� p <br /> Building Contractor: 101'7h/--;�,VcP4;, Sewer Installer: /`-1-1/P&/%Z!S <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF CONIiV1ENTS/CONDITIONS ONLY � <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Boa <br /> y Fee Rec. <br /> f� <br /> x <br /> Check#: <br /> Date of staff site visit: �/ Initials of site visit staff: <br /> a <br /> z <br /> APPROVED BY LAND SERVICES AL: ATE: <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> ID <br /> c'> <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT a R <br /> r m <br /> Transcendent: Page 1 of 4 X o c° r•> <br /> r� <br /> Laserfische: - Burnett County,WI Land Use Application —Rev 1/2019 zi; Q <br /> o m <br /> Vf <br /> v <br />