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LAND USE PERMIT APPLICATION-Burnett County,WI a r <br /> < b <br /> Applicant Complete All Sections Below This Line 7' <br /> a <br /> G Permit Types and Fees:(Please,check appropriate boxes), <br /> Dwelling/Principal Structure $3001 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/industrial Structure $3001 Addition/Alteration to Commercial/Industrial Structure $200 <br /> 70 Accessory Structure(Garage,ShAetc.) $15050 Addition/Alteration to Accessory Structure $150 <br /> Accesso Structure(Commerci0 Addition/Alteration to Bunkhouse $150Deck/Stairs/Patio/RetainingWaBunkhouse $250Drivewa s/&Cam round Stru25 WI State Statute 59.692(ly)Structures $350Filling/Grading 50 Boathouse $500 Six Month Camping Unit(One P00 Permit Extension(1 Year Extension-Allowed Once) Isloo CI, <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 o different application form;see corresponding application,and fees. 110 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> �asrP � O z <br /> Property Owner's Name: � � � � � � <br /> :ProP Property Owner's Mailing Address C'�D 11O'��" 1NF 1, IDI S�S3Is a <br /> > <br /> . IA . City State Zip o n <br /> Property Site Address: N ry • 1) Fgr� <br /> 'L� C <br /> Contact's Telephone Number:�pla-8l) sj I q o a <br /> Contact's Email: 01 h� ,"A. #,:, -1r— <br /> E 1 O <br /> Legal Description of Property: P��"i=.- 'j _! `; tt�' 8 VJ o w <br /> Section#:_AO Town#: '��N Range#: W Town of: f—u►S V, on <br /> C <br /> *Attach additional page t needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> {` 5. <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: _ �J It Q <br /> Anticipated Start Date: b , ( e/Cabin;Commercial Business;Bedroom;Deck;etc.) 11 <br /> Building Contractor: Sewer Installer:WO.&, V_UT`SYAZA M T y <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS <br /> WIZ <br /> EENTS/CONDITIONS ONLY r� <br /> THIS PERMIT IS SUBJECT COrLIS ED�OW: <br /> � z <br /> E <br /> Fee Rec: 0000 <br /> —+11 1 S� W P <br /> N Check <br /> Date of staff site vi 2i 1 o si visit staff: �r <br /> APPROVED BY LAND SERVICES OFFICI DATE: <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF r <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 03 <br /> Transcendent: {`) , <br /> Page 1 of 4 E m ...t <br /> Laserfische:= Burnett County,WI Land Use Application—Rev 1/2019 <br /> H v+ <br /> a <br /> K `` � <br />