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� b <br /> LAND USE PERMIT APPLICATION - Burnett County, WI r <br /> a <br /> <• b <br /> Applicant Complete All Sections Below This Line <br /> CD <br /> C7 <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> ommercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 UNl\ <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ~ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk I Bunkhouse $250 � <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 C. <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <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. t. <br /> z <br /> Property Owner's Name: ° <br /> Property Owner's Mailing Address: oZ � /.f tL <br /> City State_ Zip <br /> Property Site Address: 11 6 a(T LA <br /> Contact's Telephone Number: 70- 4"; 0 f y o <br /> � d <br /> Contact's Email: �l rc 4, // � 7 �tz N 'f GA. <br /> Legal Description of Property: /—0l CS U. p o 00 <br /> Section#: Town#: �N Range#: L(_W Town of: v <br /> d <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): I S 9 S T <br /> o <br /> Proposed Use of Structure/Addition: -{'�j(P A q e � <br /> Anticipated Start Date: A Sa ome/Cabin;Commercial Business;Bedroom;Deck;etc.) C7 <br /> Building Contractor: Np41� y <br /> J®�N W s.o J I /� Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z �� <br /> y Fee Re(:—" 5-0 <br /> x <br /> / Check#: <br /> Date of staff site visit: Initials of site visit staff:VIC <br /> / r—d <br /> APPROVED BY LAND SERVICES O DATE <br /> C <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> �K <br /> Transcendent: - Page 1 of 4 M;c <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 <br /> m <br /> m <br /> y <br /> a <br /> b <br />