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• about:blank <br /> LAND USE PERMIT APPLICATION— Burnett ('ounty, 'V'I <br /> Applicant Complete All Sections Below This Line 5. .... <br /> . 02 o <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) R n _ <br /> Dwelling/Principal Structure 5300 Addition/Alteration to Dwelling/Principal Structure $200 jJ <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ..,.k• 2 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 B <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> J0 Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> i/ Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r -- • <br /> Filling/Grading $150 Boathouse $500 ^ j <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aqui red 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. nR <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r-. S VIP <br /> Property Owner's Name: J ( 11 ' o, (c...,_ I m o fl <br /> Property Owner's Mailing Address:ca 9 �v – b Pd i.✓G rJ P1 Ce n lenn,i•.( 6,6 j D l . - <br /> City SEate Zip 1 '. <br /> Property Site Address: ocn 7 Li C 0 S q,�� <br /> .. <br /> Contact's Telephone Number: 303' 6 S 6 • Off( 3 7- O r �g, <br /> / r <br /> Contact's Email:W:l/,'w--• 6Cc , Q,kfF'w•.t,• (.C-0 r"` 0 d <br /> Legal Description of Property: I 4 <br /> Section#: Town#: N Range#: W Town of: • <br /> d <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 5. <br /> 9 Tax ID#(1-5 digit number;found on tax statement): 1 3 . I — a <br /> Proposed Use of Structure/Addition: 4 .-/'C -,.1/4,i r,s ., <br /> a <br /> Anticipated Start Date: 4pr Joao (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) d <br /> Building Contractor: tky(_ LJ .C .- e r Sewer Installer: y w <br /> AREA BELOW THIS LLNE FOR LAND SERVICES STAFF COMNIEENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> z • <br /> z �ti <br /> II <br /> g Fee Rec: <br /> 5Z. <br /> Check#:�2 <br /> Date of staff site visit: 7 �t:� Is site visit staff: r\ <br /> APPROVED BY LAND SERVICES OFFIC DATE: %'� ' rrid <br /> n ==1) <br /> UPON APPROVAL: APPLICANT MUST POST COPY' OF N <br /> fill <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT a W W Ste? <br /> Transcendent: Page 1 of 4 N <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2020 .. A o rn <br /> t� <br /> o n <br /> ra C:4b <br /> lilt <br /> Lc-`IJ <br /> 1 .,f d 3/31/2020- 1 0:3 1 AM <br />