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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 <br />Addition/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure $300 <br />Addition/Alteration to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) $150 <br />Addition/Alteration to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) $200 <br />Addition/Alteration to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Driveways/ & Campground Structures $125 <br />Bunkhouse <br />WI State Statute 59.692(iv) Structures <br />$250 <br />$350 <br />Filling/Grading $150 <br />Boathouse <br />$500 <br />1$100 <br />Six Month Camping Unit (One Per Year) $100 <br />Permit Extension (1 Year Extension - Allowed Once) <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: P�/� 1� -n <br />Property Owner's Mailing Address: 26536 ► y V' 1 b <br />City State Zip <br />Property Site <br />Contact's Telephone Number:SQl L' — <br />Contact's Email: AO::4 141 �1 <br />i t rr c cyn <br />Legal Description of Property: <br />Section #:_ Town #: N Range #:1�-A_W Town of: Scott <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system Property page. <br />Tax ID # (1-5 digit number; found on tax statement): <br />Proposed Use of Structure/Addition: <br />Anticipated Start Date: F40 V` 2f. s <br />(Horne/Cabin; Commercial Business; Bedroom; Deck; etc) <br />Building Contractor: S. l - Sewer Installer: �jk <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />I� <br />Date of staff site visit: <br />C-- y- �� C4 � f :,-^ <br />Initials of sit# visit <br />PERMIT APPROVED BY LAND SERVICES OFFI <br />)N APPROVAL: APPLICAN' <br />;ST 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 />i` <br />r <br />C71 <br />00 <br />N <br />Q� <br />D <br />t�– <br />4— <br />Fee Rec:(� <br />Check 41: <br />