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LAND USE PERMIT APPLICATION—Burnett County, WI <br /> Applicant Complete All Sections Below This Line o o <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) ,aw <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 `'S. <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 '� O <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 /> r <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> c4 ; <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r^ <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(l Year Extension-Allowed Once) $100 g. <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. , Zr <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. VI <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- i <br /> fie <br /> Property Owner's Name: c� - d J iA. InA 8'tL1.11 z <br /> , <br /> Property Owner's Mailing Address:1 I'34 -Y f t(A4 Q a 12d 14 [e t t ,� <br /> ity State Zip I r <br /> Property Site Address: —7 / i • i _ • _ l 8 ♦ 4 <br /> Contact's Telephone Number: its 7 33 0 QCG d 4 <br /> d <br /> Contact's Email: 11 i <br /> Legal Description of Property:©14 (ii Al 5 AQ(/QS 1. `j (21-41._k 2 VIj 'f id ! a <br /> Section#: /6 Town#: (10 N Range#: / W Town of: C.Jri.C' <br /> d <br /> *Attach additional page if needed for lengthy description OR attach a copy ofthe deed OR attach tax system property page.* 3. <br /> ,r/ 0 <br /> j'1 <br /> Tax ID#(1-5 digit number;found on tax statement): i 1(S c, <br /> Proposed Use of Structure/Addition: Octif4V 332j.""34, e 3`� ixd <br /> Anticipated Start Date: (— 2 O2 (Home/Cabin;lCommercial Business;Bedroom;Deck;etc.) p <br /> Building Contractor: A0p CC1��` ,j„�C'Q`i Sewer Installer: y <br /> 4 n --- <br /> AREA <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: -k, <br /> 0 / O kc L p 0.o <br /> Fee Rec:_ e <br /> i y Check#: ii 231 <br /> m <br /> Date of staff site visi ...--c--) <br /> d <br /> ') /)j tials of site visit staff: y 1 <br /> VLd'------------- <br /> APPROVED BY LAND SERVICES OFFIC DATI ^36ao < s_Jl <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF co <br /> y , <br /> 9, <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z0 CD <br /> CD <br /> 0 r <br /> 0 <br /> Transcendent: - Page 1 of 4 �. o <br /> Fa <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2020 < a <br /> d a MI <br />