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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 <br />$3001 <br />Addition/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure <br />$300 <br />Addition/Alteration to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) <br />$150 <br />Addition/Alteration to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) <br />$200 <br />Addition/Alteration to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Bunkhouse <br />$250 <br />WI State Statute 59.692(1v) Structures <br />$350 <br />Driveways/ & Campground Structures <br />$125 <br />Filling/Grading <br />$150 <br />1 <br />Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) <br />$100 <br />1 <br />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: 31l,I ' Q�11' _ �_ _ ___ _ <br />Property Owner's Mailing Address: --r- wer Q t) S <br />City f State Zip <br />Property Site Address: 3 D 4G S ���yJl E c) c ,A <br />Contact's Telephone Number: / 1 J 2 <br />Contact's Email: S (_ , <br />Legal Descriptionpf Property: �e t ortk A 4 fP O r S s� <br />Section #: 2-j/ Town #:_t)_N Range #:�W Town of: -. I <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />n <br />Tax ID # (1-5 digit number; found on tax statement): � <br />jj <br />J&0' <br />Proposed Use of Structure/Addition: 1" 1-4&0 <br />Anticipated Start Date: 5 rM 0 1 ome/ abin: ommercial Business: Bedroom: D ck: etc) <br />Building Contractor: 6ya 0", C 6U41 ice-' Sewer Installer: <br />INE <br />AREA BELOW THIS FOR %AND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />--Nd �L4 JA^Qh �ja�l a77ovl aI�OG�P.� /L - tA IS S�N�1G�Zfi'L, <br />q � <br />Date of staff site visit: l / Initials of site visit staff: <br />APPROVED BY LAND SERVICES OFFICIAL: L DATE: Z Z <br />UPON APPROVAL: APPL CANT MUST 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 1/2019 <br />0 <br />B' <br />as <br />t7 <br />CD <br />r <br />C7 <br />m <br />0 <br />G� <br />0 <br />o <br />cn <br />a <br />iv <br />z <br />0 <br />o � <br />C7 <br />v <br />ro <br />ao <br />Qn <br />� d <br />z <br />x <br />Fee Rec: <br />y Check #: 6913 <br />0 <br />z <br />o <br />m <br />a) <br />z� <br />_.-a <br />o�( <br />z yn <br />v <br />m� <br />N <br />r� <br />o ^' <br />