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f <br /> a LAND USE PERMIT APPLICATION—Burnett County, WI t~ <br /> Applicant Complete All Sections Below This Line 3' <br /> _a <br /> Permit Types and Fees:(Please,check appropriate boxes) p <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> ,Commercial/Industrial Structure 00 Addition/Alteration to Commercial/Industrial Structure $200 00 <br /> Accessory Structure(Garage,Shed,etc.) Addition/Alteration to Accessory Structure $150 <br /> 1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 � <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 C- <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 1 Permit Extension(1Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fad permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers i Ica ion arm;see corresponding app I <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. �. <br /> l � z <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: <br /> City State Zip <br /> Property Site Address: <br /> O y <br /> Contact's Telephone Number: '" o <br /> T/�iOaGJ <br /> Contact's Email: �a�/ —14:L WK <br /> Legal Description of Property: 4o7 3 G.��'t V 3� o nQ <br /> n <br /> R. <br /> Section#: 0 Town#:Y_N Range#:�W Town of: U <br /> C7 <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): / 4P <br /> Proposed Use of Structure/Addition: Boce f -S�✓'a 9 a <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) C7 <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> � /D7'- Tv �e. U5Ca/ 4 t/' ! u V--,,-t H ��t �a jLlp� r z <br /> Fee Rec: <br /> Date of staff site visit: 7 3 1 Initials of site visit staff: <br /> z I3ffprev- I/l <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> Co <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <C �_ Cs� <br /> Transcendent: <br /> Page 1 of 4 0 0 0 <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 < m M o <br /> o -3 to <br /> W <br /> b <br />