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LAND USE PERMIT APPLICATION— Burnett County, WI a g <br /> Applicant Complete All Sections Below This Line 6' c lzo <br /> Permit Types and Fees:(Please,check appropriate boxes) d cJ\ <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `�4) <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0 E <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> G) `i <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° • <br /> Filling/Grading $500 R �1 ; <br /> g g $150 Boathouse <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> c0 <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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. - as�X^ r <br /> Property Owner's Name: l h�� 5 4 Law- rv, ,a - k ° z , <br /> 0 <br /> Property Owner's Mailing Address: X01\ 111'\t la aw.et\ ux 541 a ' <br /> City State Zip b <br /> Property Site Address: S�Ke = v,ih. <br /> s <br /> l <br /> Contact's TelephoneNumber: (5 ` �O8 c')L 3 o N <br /> P. <br /> Contact's Email: C\ACO r m @ C3 C W\C G , C1e,--\- o . <br /> CD <br /> Legal Description of Property: ., <br /> Section#: `-7 Town#: N Range#: / —7 W Town of: 00 <br /> C-1 i�Cs 0 <br /> E. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> Tax ID#(1-5 digit number; found on tax statement): 2 �('°9 <br /> Proposed Use of Structure/Addition: C-`\G.r cC `n <br /> Anticipated Start Date: `" /0--.2x) Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ox <br /> = o <br /> Building Contractor: Sewer Installer: p�` <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Ilk N <br /> THIS PERIVIIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to ; <br />