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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 />X <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 />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(iv) Structures <br />$350 <br />Driveways/ & Campground Structures <br />$125 <br />Filling/Grading <br />$150 <br />Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) <br />$100 <br />Permit Extension (1 Year Extension - Allowed Once) <br />$100 <br />*NOTE: After -the -fact permits (permit aquired after construction has begun) may cost up to three times the normal fee. <br />*Communication Towers & Signs require a different application form; see corresponding application, and fees. <br />*items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: <br />Property Owner's Mailing Address: 7el /gO/ <br />ta te <br />Property Site Address: Z`3-7-7 Ov UqY� pw y liti.Z S �3 <br />Contact's Telephone Number: <br />i <br />Contact's Email: <br />Legal Description of Property: <br />Section #: Town #:'�N Range #:VA�2 _W Town of: <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />Tax ID # (1-5 digit number; found on tax statement): <br />Proposed Use Structure/Addition: <br />of <br />Anticipated Start Date: (h ome/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: 'SN Sewer Installer: C� <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />PERMIT <br />$ Z LO' yb o,� S aK I ,7 ry S yS T 16,74 7� <br />ex� z b� �s <br />-� s h'14 e-� VX- h o f uy i, t .V r � © -Fe <br />/'VI a tie S u l� 9� irP�tJa y lNt le i e__ Z 0 lceo <br />h o f cLu y r 5 l A v/ k /74 <br />ne 30�19, <br />n2o <br />Date of staff site visit: ��3D// q Initials of site visit staff: T 11 /' <br />APPROVED BY LAND SERVICES OFFICIAL: <br />DATE: <br />UPON APPROVAL: APPLICANT 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 />w <br />o. <br />M <br />CD <br />CD <br />00 <br />N <br />O <br />3 <br />U5 <br />