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LAND USE PERMIT APPLICATION — Burnett County, WI a. b <br /> Applicant Complete All Sections Below This Line e <br /> Permit Types and Fees:(Please,check appropriate boxes) C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 q <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 l?� <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 "— <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 V� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 < <br /> Filling/Grading $150 Boathouse $500 c <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. Z� <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r� <br /> Property Owner's Name: <br /> 0 <br /> Property Owner's Mailing Address: <br /> nn .fin ^y� City State Zi <br /> Property Site Address: Z(� b,5 5 ''� `t I\Q`r klQ C i l �lt1W�` w r ��193 <br /> Contact's Telephone Number. CID <br /> Contact's Email: vol Kec Ca M • C-OV' , d <br /> Legal Description of Property: n - c73 2 ` Z 0 S 't o 1- ��of 8 d <br /> c vo <br /> Section#: 3� Town#: `4 1 N Range#: W Town of: $W S <br /> Uq <br /> *Attach additional page if needed for lengthv description OR attach a cop)!of the deed OR attach tax.rvstem property page.* t7 <br /> r <br /> Tax ID#(1-5 digit number;found on tax statement): 7 OR <br /> W <br /> Proposed Use of Structure/Addition: ` 3 -� <br /> Anticipated Start Date: (Home/Cabin:Commercial Business;Bedroom:Deck;etc.) E � <br /> o C7 <br /> Building Contractor: - 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 /> **The applicant needs to contact their LDC Inspector to determine if a permit is needed front them prior to <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured z <br /> home additions, and bunkhouses.** <br /> �rcrr\ <br /> - Fee Rec:1.160 <br /> K, Check#: e90 1 j <br /> Date of staff site visit: (p Initials of site visit staff: <br /> APPROVED BY LAND SERVICES OFFICIAL DATE: :3 m� . <br /> • POST COPY OF <br /> UPON APPROVAL. APPLICANT MUST O v <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Ei <br /> Transcendent: - Page 1 of 4 <br /> Burnett County, WI Land Use Application —Rev 6/2020 a <br /> Laserfische: - -- <br />