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LAND USE PERMIT APPLICATION - Burnett County9 WI � b <br /> y N <br /> Applicant Complete All Sections Below This Line 0 � e <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Comm CD <br /> Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> I Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> A <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 n <br /> Driveways/&Campground Structures $125 WI State Statute 59.592(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 r vvv <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fad 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 accessary structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: 16 o cc- �v t� Yl yt <br /> Property Owner's Mailing Address: ✓ ` '� '��� o <br /> / _ I , V� Cit <br /> L 7 � _001ey ZiP <br /> Property Site Address: � <br /> Contact's Telephone Number: �� 1�— 3 tD 3 — �a / u DU <br /> to r —A vL K n <br /> Contact's Email-- _� c+►'(�(�. a d <br /> Legal Description of•Rroperty:� t --7CD <br /> re-,A) o I <br /> IQ <br /> Section#: Town#:_� N Range#: � ' Town of: �- . <br /> 00 <br /> *Attach additional page if needed for lengthy description OR attach a cony of the deed OR attach tax system property page.* t7 <br /> Tax ID#(1-5 digit number;found on tax statement):_— <br /> --,� _ �e <br /> Proposed Use of.Stt�cture/Addition: — <br /> Anticipated Start Date: �,�n ,f`L (Home/Cania:Commercial Business;Bedroom;Deck;etc.) <br /> 1.3uilding Contractor; e Scwer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **!'lie applictint needs to contact their UDC Inspector to if a perinif is.iteeded front them prior to <br /> Ai'Y construction talaiig place fi r arty dwellinAA s,diveflin t <<pititt:, ¢tttitufaa turett Izotnes,inatit{factored z <br /> h«nre additirzYts,..rrad bunkhouses.*" yam <br /> 44 <br /> ` f <br /> bN <br /> s` Fee Rec: <br /> Check#: <br /> —" /— —'15 Initials of site visit staff: r <br /> Date of staff site visit. _-- c=--= <br /> .?.PPROVED BY LAND SERVICES <br /> ��-ry � <br /> U��'rp APPROVAL:PPROVAL: AP°_�'�LICAN,I' MUST 1 OST COPY <br /> OF ai I" <br /> SIGNED I�MIT AP`PI�I � ' ,?.10N Ill PLAIN SIGHT o -� <br /> _Transcendent: Page Y of 4 �� � �•� <br /> - <br /> - _ Burnett County, 'Wl Land Use Application —Rev 6/2020 <br /> Laserfische: <br />