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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 />$300 <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 />I <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 />Driveways/ & Campground Structures <br />$125 <br />WI State Statute 59.692(1v) Structures <br />$350 <br />Filling/Grading <br />A$15O <br />Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) <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: landscaping, etc. <br />iip--ergolos, <br />Property Owner's Name: U.K Lm&(�- <br />Property Owner's Mailing Address: • (a L« J +► CA-) (p 5tj I'i <br />City State Zi <br />Property Site Address: � y� K 11 * -,! S t-va�, `h o <br />pLaoy <br />C <br />Contact's Telephone Number: �� 1 0 J 1 J Zq JDh y <br />)+�� <br />Contact's Email:LolC�e to kL4m�CC(V1 <br />Legal Description of Property: n �• �,( tti J lti ' rJ� '� h'1 <br />Section #: Town #: N Range #: I W Town of- b&j1 t <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): 2 <br />Proposed Use of Structure/Addition: t'� n <br />Anticipated Start Date: m04 (Home/Cabin: Commercial Business; Bedroom: Deck: etc) <br />Building Contractor: M4 "re- Sewer Installer: —,:f,- —o <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />3 be.c�r�or� �1ow1e- �,•�� a 3 6�i ova 5Q "`l'%ry <br />51�57rv+^ <br />Date of staff site visit: Z / / Initials of site visit staff: r /! <br />APPROVED BY LAND SERVICES OFFICIAL: ,.� DATE: J� <br />UPON APPROVAL: APP ICANT 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 />r <br />0 <br />Fee Rec: 7 <br />Check <br />C <br />o. <br />� m <br />1- <br />Cs� <br />2� <br />V� 0 <br />00 <br />L� <br />c� <br />C= <br />m <br />(� <br />