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LAND USE PERMIT APPLICATION — Burnett County WI r <br /> Applicant Complete All Sections Below This Line 3' ~ <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> 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 /> CD <br /> Accessory Structure(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(ly)Structures $350 �. <br /> Filling Grading $150 Boathouse <br /> $500 0 <br /> Six Month Camping Unit(One Per Year) $100 jPermit Extension(1 Year Extension-Allowed Once) $100 m <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. Q <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. o <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> z <br /> Property Owner's Name: �a,rn <br /> nn � <br /> Property Owner's Mailing Address: , t C), �, 11 Q O— 4 (-,,- ` yf� I t) <br /> City State Zip <br /> Property Site Address: <br /> N <br /> Contact's Telephone Number: — p" Cps �A S a <br /> ran: cy d <br /> Contact's Email: 1'tl rl U N 1 <br /> Legal Descn*ptioq of Property: o <br /> Section#: �--L Town#:�QN Range \A_W Town of: �j w <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(R � <br /> Proposed Use of Structure/Addition: y o x <br /> Anticipated Start Date: (Home/Cabin;Comme Business;Bedroom;Deck;etc) � C7 <br /> Building Contractor?NN�\r 14 �' IS&JN S C 5� Sewer Installer: <br /> n <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 00 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Na+ For z <br /> Fee Rec: <br /> Check#:- <br /> Date of staff site visiti Initials of site visit staff: <br /> D <br /> APPROVED BY LAND SERVICES OFFICIAL <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF W M <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 0 C <br /> Transcendent: Pa e 1 of 4 �` cc <br /> g 3 <br /> Laserfische: Burnett County, WI Land Use Application—Rev 1/2019 <br /> 3 <br />