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LAND USE PERMIT APPLICATION - Burnett County, WI r <br /> a � C! <br /> Applicant Complete All Sections Below This Line �o <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ^ <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 J) <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150j CD <br /> \ <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk IBunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 r• <br /> Filling/Grading $150 lBoathouse $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 aqui red 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 /> z <br /> Property Owner's Name. <br /> 0 <br /> Property Owner's Mailing Address: ( R I yfl V uce-S I.4L,64- Ira- j <br /> City State Zip rn„ <br /> Property Site Address: `z 3 L <br /> o � � <br /> Contact's Telephone Number: (p�1 — 'Z 8-3 - G 2y 7- <br /> d <br /> Contact's Email: b <br /> Legal Description of Property: S 1 /���Q I vs Lc.� ��` 0.n,Q Sqr� 5,•3 <br /> Section#: Town#: N Range#: W Town of: <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax sy m property page. <br /> Tax ID#(1-5 digit number;found on tax statement): -? 73 0 <br /> Proposed Use of Structure/Addition: tf , / ca Q 41 x <br /> Anticipated Start Date: $-!S-/9 (Home/Cabin;Commercial Busin s;Bedroom;Deck;etc.) ° d <br /> Building Contractor: S�e� C�.ts fra�h..� S c--�LSSewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF CONI--NIENTS/CONDITIONS ONLY <br /> THIS PERMIT IS� SUBJE�T TO ALL CONDI;'IQNS LISTED BELOW: CJ ev\c-P- V-Qmove c7<- MOV'ed ba C- K- <br /> z Fee Rec: 3 <br /> F Check#: <br /> o <br /> Date of staff site visit. Initiallsof site visit staff: r <br /> z <br /> Q o <br /> APPROVED BY LAND SERVICES OFFICIAL <br /> UPON APPROVAL: APPLICANT MUST POST COPY OFCD C3 <br /> 5.3 � <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTWul <br /> m <br /> r 00 <br /> m c C <br /> w`:3 C""J <br /> Transcendent: - Page 1 of 4 m <br /> Laserfische: - Burnett County,WI Land Use Application-Rev 1/2019 FU <br />