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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 />$300rAddition/Alteration <br />dition/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure <br />$300 <br />to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) <br />$150dition/Alteration <br />to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) <br />$200dition/Alteration <br />to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />nkhouse <br />$250 <br />State Statute 59.692(1v) Structures <br />$350 <br />Driveways/ & Campground Structures <br />$125 <br />Filling/Grading <br />$150 1 <br />Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) <br />$100 1 <br />jPermit 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: <br />Property Owner's Mailing Address: <br />City. State Zip <br />Property Site Address: <br />31q�1 �~ <br />Contact's Telephone Number: 71 `� 5�-3 ` C:a'� D 'I <br />C Iulc- t C-0-5L6(ft•°19 <br />Contact's Email: <br />Legal Description of Property: /I/A,:*'/V � <br />Section #: d 3 Town #: -41 N Range #: 1 S W Town of: �% 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): Q (� S <br />Proposed Use of Struc ddition: 6 1,t17k%d ti- , 6� n <br />z <br />Anticipated Start Date: jam' (Home/Cabin; Commercial Business; Bedroom; Deck; etc) <br />Building Contractor: Se / r- Sewer Installer: /) 4114 <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW' <br />J� <br />�0 0441 Safi► � �trk",�/�O /ssue2 <br />/A ' /ow <br />�( <br />o,s a <br />�ez <br />0 D 114 d �- T �a vt 7 <br />qq n <br />, <br />�a/l,� SUS S eA q CA— S /^� G / Gt �ti <br />.- <br />Date of staff site visit: / Initials of site visit staff: <br />APPROVED BY LAND SERVICES OFFICIAL: <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 />C" <br />b <br />G� <br />0 <br />0 <br />0 <br />r <br />0 <br />5 <br />Fee Rec:i���� <br />Check #: -7-7-)_- <br />� <br />a <br />tJ a IJ <br />m r <br />D- <br />-< <br />l� <br />r'J <br />C ° <br />lrttt <br />N0 <br />W <br />v <br />0 <br />C <br />