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LAND USE PERMIT APPLICATION - Burnett County WI b <br /> Applicant Complete All Sections Below This Line o N <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) � <br /> Dwell in /Princi al Structure <br /> g p $300 Addition/Alteration to Dwelling/Principal Structure 200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure 0 <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 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r- U <br /> Filling Grading $150 Boathouse $500 <br /> o b <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(i Year Extension-Allowed Once) $100 <br /> m <br /> 0 <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. <br /> z <br /> Property Owner's Name: 22 <br /> Property Owner's Mailing Address: "Z--ZAJ J&tw A-,UL- -UvL iwta SS(OS z <br /> Property Site Address: 6 City State Zip <br /> p Y � �O 2 �✓4`FR�t.u�.. 11ttt.�; �Aw f��vK..�f `,�J�. C <br /> O y <br /> Contact's Telephone Number: 1.051 i a d <br /> d � <br /> Contact's Email: ', r R.v st—ho-c ad lig n <br /> Legal Description of Property: 'fix C e. 7 4`70 'ji X4j t<' L4,1- 1 G!,t•1 V �^G'c2� •5 t <br /> Section#: Town#: _N Range#: W Town of: SW i 5-S <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 /> n <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: fzcr� o v <br /> Anticipated Start Date: eIAm '`001 2�0Z,a (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) � C7 <br /> Building Contractor: eoy"J i1 '5wWtw g Sewer Installer: y <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 /> z <br /> �/.,^u0 <br /> Fee Rec: (;l L�— <br /> U Check#: <br /> Date of staff site visit: Initials of site visit staff: <br /> APPROVED BY LAND ERVICES 14ICI—���� <br /> DATE: X =--� <br /> n � <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z+0� M <br /> Transcendent: 00 <br /> w � Cj <br /> Page 1 of 4 m , r�a Q <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 <br /> m .�* <br /> 0 <br /> Y <br /> K <br />