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LAND USE PERMIT APPLICATION — Burnett County, WI <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 <br />$200 <br />Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) $150 Addition/Alteration to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse <br />$250 <br />Driveways/ & Campground Structures $125 WI State Statute 59.692(ly) Structures <br />$350 <br />Filling/Grading $150 Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) $100 1 Permit Extension (1 Year Extension - Allowed Once) <br />$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 />Property Owner's Name: �iyt Ahy ,ZI <br />Property Owner's Mailing Address: �/b �!� 07 �i %' �� /��-1-rQfr 7`i 11,7/1 • <br />/ City State Zip <br />q yN� <br />Property Site Address: <br />Contact's Telephone Number: /d%_ `07—? 1- GPi( <br />Contact's Email: le c2i;`-It C-It. o <br />r/I0 <br />/ <br />Legal Description of Property: <br />707 <br />Section #: f,- Town #: N Range #: W Town of: 14 1c9/ -f <br />*Attach additional page if needed for lengthy description OR attachcopy of the deed OR attach tax system property page. " <br />f <br />Tax ID # (1-5 digit number; found on tax statement): <br />Proposed Use of Structure/Addition: <br />Anticipated Start Date: �� T _� .1 O� (Home/Cabin; Commercial Business; Bedroom; Deck; etc) <br />Building Contractor: Sewer Installer: <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />60; ,1 � �,�� VV\X-) 5� 61z- 3 d -b r 6 <br />\�J6� a Y-�D� <br />0 <br />Date of staff site visit: 9 X Initials of site visit staff: <br />PERMIT APPROVED BY LAND SERVICES <br />UPON APPROVAL: APPLICANT( <br />DATE: l� <br />UST POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Transcendent: - Page 1 of 4 <br />Laserfische: Burnett County, WI Land Use Application — Rev 8/2018 <br />r <br />En <br />` � c <br />OV <br />w �.a <br />CD <br />C C <br />G <br />a ^� <br />W <br />( rs <br />�O G <br />S <br />^o <br />oC, <br />z —U <br />ITI <br />S C <br />o' <br />� 5 <br />o a <br />J d <br />d <br />CD <br />0 0% <br />n <br />opo <br />d <br />y <br />o m <br />o G <br />z � � <br />x v� <br />s Fee Rec: r <br />Check #: <br />U. <br />