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LAND USE PERMIT APPLICATION - Burnett County, WI <br /> Applicant Complete All Sections Below This Line c o <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Vk <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> V Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> L/Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 q <br /> ,-- <br /> AccessoryStructure Commercial Industrial <br /> (Commercial/Industrial)) $200 Addition/Alteration to Bunkhouse $150 n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r. '` <br /> Filling/Grading $150 Boathouse $500 �` <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 `" <br /> F <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- 5 <br /> /J Wail) .2,fr - ari J-LG z <br /> Property Owner's Name: ,z, <br /> p g 'J a� I�tt;Y 'i S (— 7 7 �/�N��{R X L(.� S- S & <br /> Property Owner's Mailing Address: <br /> -7 't-,- <br /> City State Zip = �„ <br /> Property Site Address: / ��o rn$'A/65-6. <br /> t d 71- '' i <br /> Contact's Telephone Number: 7'S 6c -31/1 . 7` a ' <br /> L on . •• <br /> Contact's Email: s CAR/4i Ri S G fi Q Cr ,! , �tx�r <br /> Legal Description of Property: N (ro <br /> B. <br /> Section#: ais, Town#: it J N Range#: /i W Town of: Sit);SS <br /> u. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach taxsystem property page.* q <br /> n <br /> �2 I <br /> ` <br /> Tax ID#(1-5 digit number; found on tax statement): 314 '7 J 0 ,,, <br /> H <br /> Proposed Use of Structure/Addition: armikir.tj B i„1,/��,NR2Q1 k <br /> Anticipated Start Date: i') -,g0 g-O' (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) a C7 <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY r <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Aoki Sr•-o 6.caress k,/ autyke. (1 acs-'o2o m <br /> x Fee Rec: 5� <br /> Check#:1--4 0. <br /> Date of staff site visit: ' L Initials of site visit staff: y � <br /> z <br /> APPROVED BY LAND SERVICES OFF AL: —6-5--.----s - DATE: 3'ezP?-..... ..20 Po = <br /> 0 �. <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ' ,m a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 4, rU <br /> Transcendent: Page 1 of 4 =' <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 .CD <br />