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LAND USE PERMIT APPLICATION— Burnett Countv, WIEn <br /> C <br /> ro <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 = �� <br /> r <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `" <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 /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ,) <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(iv)Structures $350 < <br /> Filling/Grading $150 Boathouse $500 r- — <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(lYear Extension Allowed Once) $100 <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. <br /> i <br /> Properly Owner's Name: 4�.��.1 -� c <br /> Property Owner's Mailing Address: <br /> ity State Zip <br /> Property Site Address: & .12 c o RL n <br /> Contact's Telephone Number:)i 7 `]_5 -7 5 5 2S •`.. <br /> Contact's Email: A �-�RL� �ili <br /> —Legal Description of Property: <br /> 'v <br /> Section#: _Town T:_��N Ran-e W Town of: <br /> *Attach additional age if needed for lengthy description OR attach a co o the deed OR attach tar system ro ern, aoe. <br /> P � P PY f P P P � o <br /> Tax ID (1-5 digit number; found on tax statement): <br /> —� <br /> Proposed Use of Structure.'Addition: <br /> Anticipated Start Date: — (Home.Cabin:Commercial Business;Bedroom:Deck:etc.) x <br /> Building Contractor: Sewer Installer: r v <br /> AREA BELO«'THIS LINE FOR LAND SERVICES STAFF CONINIENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> "The applicant needs to contact their UDC Inspector to determine if a permit is needed front then prior to <br /> A.VYconstruction takin;place fur an),dwellin-.s, dwellin;additions, manufactured hones, manufactured z <br /> home additions,and bunkhouse���� Fb <br /> 1 Fee Rec.Check#:3QZ <br /> Date of staff site visit: Initials of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICI. DATE: <br /> 1 GoC= <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT n " <br /> �o o <br /> z <br /> c <br /> x C �u <br /> Transcendent: - Pale 1 of 4 CD Laserfische: - Burnett County, `VI Land Use Application— Rev 6/2020 '- <br />