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LAND USE PERMIT APPLICATION - Burnett County, WI r <br /> a � <br /> Applicant Complete All Sections Below This Line c o <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 /> f <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 /> M <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> r, Ga <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> 10 <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 not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r <br /> 0 <br /> z <br /> Property Owner's Name: br r j sm Kinintr ° <br /> Property Owner's Mailing Address: �r NIA TLu lG3'l'ra' 1 lW 90 o <br /> City ate Zip <br /> Property Site Address: 11 every (� 51930 <br /> Contact's Telephone Number: .56-7 - alyq 0 3:3 n <br /> / d <br /> Contact's Email: QYt klenn er @ olO-A ' co m <br /> Legal Description of Property: & a C. SM Y t P 4q o <br /> L o� <br /> Section#: .561 Town#:T O fv N Range#: R tD W W Town o£� QG ;�h <br /> d <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): 4` i6 1 <br /> Proposed Use of Structure/Addition: (--:d Yo4e, <br /> Anticipated Start Date: /y+ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: ,Se55G el z la4T Sewer Installer: NI <br /> 1 <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 /> Fee Rec: / <br /> Check#: <br /> G <br /> Date of staff site visit: �� D itials of site visit staff: <br /> z <br /> r- m <br /> APPROVED BY LAND SERVICES OFFIC�AL: DATE: <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF � <br /> Q <br /> y w03 > <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ? M <br /> C <br /> Transcendent: - 00 C rs o <br /> Page 1 of 4 m <br /> Laserfische: Burnett County, WI Land Use Application—Rev 1/2020 M 3 <br /> v w <br /> a <br />