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Cn IV <br /> LAND USE PERMIT APPLICATION—Burnett County, WI & <br /> b <br /> Applicant Complete All Sections Below This Line <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300rAddition/Alteration <br /> Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150Alteration to Accessory Structure $150 N\ <br /> Accessory Structure(Commercial/Industrial) $200ation to Bunkhouse $150 <br /> C) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk e $250 <br /> Driveways/&Campground Structures $125tatute 59.692(1v)Structures $350 C. <br /> Filling/Grading $150 1 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 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. r <br /> // 11 a o <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: ( <br /> _11 City State Zip <br /> Property Site Address: AIDj'S Ai,k e V` 4 cA V►1 u 3 <br /> 0 <br /> Contact's Telephone Number: 0370 <br /> Contact's Email: u C'�fi�1 j • G��1�1 <br /> CD <br /> Legal Description of Property: (�1 N C <br /> Section#: 5 Town#:_YL_N Range#: W Town of. S w SS o <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 /> o' <br /> Tax ID#(1-5 digit number;found on tax statement): I a I gy 7 <br /> Proposed Use of Structure/Addition: S k eC4 <br /> Anticipated Start Date: /491a(a//q (Home/Cabin;Commercial Business;Bedroom;Deck;etc) � C7 <br /> Building Contractor: S e, Sewer Installer: AIA <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 90+ �--ki CDYI\ <br /> < <br /> x Fee Rec: - { <br /> c <br /> Check#: 5 <br /> Date of staff site visit: ( ln' ' is of site visit staff: <br /> BY LAND SERVICES OFFI �AAPPROAVED <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF C, <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Transcendent: - Page 1 of 4 C c� <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2019 �` 40 <br />