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LAND USE PERMIT APPLICATION — Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line ' <br /> P- 1 <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> V Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 \ <br /> AccessoryStructure Commercial/Industrial( ) $200 . Addition/Alteration to Bunkhouse $150 � <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r. <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $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. ro <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. �. <br /> o <br /> Property Owner's Name: <br /> -n <br /> o` <br /> Property Owner's Mailing Address: <br /> 2 <br /> City State Zip <br /> Property Site AcIdres�: 1-ej�,(jv— L p 7-0 <br /> y <br /> Contact's Telephone Number: / � rQ a <br /> L,41<e. LN <br /> 0 <br /> Contact's Email: 0 <br /> Legal Description of Property: r��7 - �i 2. - y f 4/'-- 61-) -Qf'jc'�,�> � w� <br /> Section#: Town#: N Range W Town of: !- ago <br /> *Attach additional a e i needed or lengthy description OR attach a co o the deed OR attach tax system ro er a e.P g f f S Y P PY f Y P P t1'P g ., <br /> Tax ID#(1-5 digit number; found on tax statement): 1119 , p <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: "' ome/ abid;Commercial Business;Bedroom;Deck;etc.) O <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 /> z <br /> z <br /> x Fee Rec <br /> '^ Check#: <br /> 14 <br /> Date of staff site visit: 6 L Initials of site visit staff: <br /> APPROVED BY LAND SERVICES OFF _DATE: � <br /> UPON APPROVAL: A PLICANT MUST POST COPY OF C 03 <br /> si C� <br /> >1 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT In (Jtlu(D <br /> 0o <br /> Transcendent: - Page 1 of 4 3 <br /> Laserfische: - Burnett County, WI Land Use Application -Rev 1/2019 _ M <br /> d <br /> a <br />