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LAND USE PERMIT APPLICATION-Burnett County, WI 6 c <br /> Applicant Complete All Sections Below This Line <br /> a <br /> o <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 1 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure J$200 <br /> Addition/Alteration to Commercial/Industrial Structure $200 <br /> AccessoryStructure(Garage,Shed,etc.) Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) Addition/Alteration to Bunkhouse $150Deck/Stairs/Patio/Retainin i ewa Bunkhouse $250 <br /> Driveways/&Cam round Structures jWl State Statute 59.692(ly)Structures $350 �. <br /> Filling/Grading $1S0 Boathouse $500 °^ <br /> Six Month Cam in Unit One Per Year $100 P IevdL $100 L <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> Communica ton lowersSigns require a different app,cation orm;see correspon ,ng app,ca,on,an ees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,londscapin ,etc. r <br /> 3 .+ <br /> z , <br /> Property Owner's Name: r'2c Fi Gne rOesSJe ✓' ,� <br /> 0 <br /> —T3gp7 c <br /> Property Our.Pr's Mailing Address: Q % A�d <br /> City State—) Zip s <br /> Property Site Address: 027(0 89 9.3 N <br /> Contact's Telephone Number: 60 7 L <br /> Contact's Email: <br /> IUne drt?PSSf`f'/"ep G mc„ /, eay✓1 <br /> Legal Description of Property: Pja - d f %;,j%„ J5 ,-,k c (-, nee/. ry+"'1 4 :s(4 /I ro <br /> Section#: Town#: N Range 4: W Town of: w <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): /t/3 i/(r, <br /> Proposed Use of Structure/Addition: G b to o <br /> Anticipated Start Date: (Home/Cabin:Commercial Business:Bedroom:Deck:etc) � d <br /> Building Contractor: .S'e/F 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 /> a <br /> —, Fee Rec: <br /> z <br /> Check#: t:oQOy <br /> M, <br /> Date of staff site visit: G Initials o site visit staff: <br /> l o <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE � ��o�C7 7 ..�.�" <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT m <br /> Transcendent: - Page 1 of 4 H c� o <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 gm `o <br /> an <br />