Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI ot g <br /> Applicant Complete All Sections Below This Line o <br /> fl. <br /> ' <br /> Permit Types and Fees:(Please,check appropriate boxes) p N <br /> XC Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200g, 01 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ',J V <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 � <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° V <br /> $500Filling/Grading $150 Boathouse o. N, ,^ <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> cn <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. = <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> o ' <br /> Property Owner's Name: /4C) //A 7e 7 o _, <br /> Property Owner's Mailing Address: %4:///5-‘/ lip 4,11 -0 ° <br /> � 0 City State Zip <br /> Property Site Address: fp/)c- /g4 t✓�Y ra G Cj�l'.,,iP+' ler_ -7-.Li k/• ttk, 4,a,,- 1,1 5' n CQ <br /> Contact's Telephone Number:. . A 2- al)g— C' 9/ <br /> ff . <br /> Contact's Email: /9 i" I R‘1 AGtt -t9t/IV e/ 142/ 'z.. 4:024yf o <br /> Legal Description of Property: .5 Lc.j/y of jilt 4' 0 SC'e7' -7 <br /> N <br /> Section#: ,�4' Town#: 4U N Range#: /9 W Town of: 51e,1 0. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* q7 <br /> Tax ID#(1-5 digit number;found on tax statement): /d' <br /> d� <br /> C <br /> Proposed Use of Structure/Addition: _ H <br /> r <br /> Anticipated Start Date: AIA c21 (Nome/Cabin:Commercial Business:Bedroom:Deck:etc.) ox <br /> Building Contractor: "26,Itykii C fl,tW C/72 <br /> //I <br /> 01,(444-7Sewer Installer:/14 4/L'�7G CX-Cetv.;, <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY i '*6 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 01 <br /> lb <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** <br /> Pzi <br /> da$a be r►'la;✓! R4CQ of <br /> a IL)e t! 5TH ® U <br /> j, LI -ie l4.1;s s.4bd:vid <br /> 6' e c JI ses <br /> Fee Rec:30,3(9 <br /> y Check#: S <br /> /-1 /2:7/?..1 rn <br /> L ,_ <br /> Date of staff site visit: Initials of.ite visit staff: z , <br /> • <br /> APPROVED BY LAND SERVICES OFFICIAL: ' ° d / / / DATE: lit / Q < 11) <br /> UPON APPROVAL: APPLICANT M ST POST COPY OF a v W -78 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° o CO) w <br /> Transcendent: - Page 1 of 4 .'< t C <br /> Burnett County, WI Land Use Application—Rev 12/2020 (('i� <br /> Laserfische: - m .. <br /> o <br /> a <br /> v <br />