Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI a r <br /> Applicant Complete All Sections Below This Line o <br /> o. <br /> Permit Types and Fees:(Please,check appropriate boxes)1 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> n <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `" <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 \ £O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ,n, <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $2501 <br /> 0 <br /> Driveways/&Campground Structures X12 WI State Statute 59.692(1v)Structures $350 o <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 t <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. a <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 /> `` r 0 <br /> Property Owner's Name:I— A/%S J. Se kA�td r z <br /> P P <br /> Property Owner's Mailing Address: (bte E Ccaem/ort br i VC Nud�?r) (,j, 5g014 Q <br /> City State Zip Ts <br /> Property Site Address: 3a 35 waSh burn L.eene, She.l 1 1-�Ke t iv/ 5 I/8'7/ <br /> 3 <br /> Contact's Telephone Number: L 61 '3 3(o-03-71 0 - <br /> C <br /> a <br /> Contact's Email: 4rav,. Sc hneidetVhetconan cam.corn v <br /> Legal Description of Property: Lof j CSw► V Z P 14 C 1N boy to+a) .. <br /> N b <br /> Section#: Town#: ODI N Range#: W Town of: Dewey = °° <br /> 5 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* G <br /> Tax ID#(1-5 digit number;found on tax statement): 3ag3 n' <br /> Proposed Use of Structure/Addition: Shit 6.41 }0 W°LA-Vt. w <br /> Anticipated Start Date: 515/a 1 (Home/Cabin:Commercial Business;Bedroom;Deck;etc.) F p <br /> Ei <br /> Building Contractor: R ha rc.1 Cole, Sewer Installer: <br /> -i W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY \ gz <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: W <br /> **The applicant needs to contact their GDC 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 2 <br /> home additions, and bunkhouses.** xi <br /> Fee Rec: 1 otb - <br /> EC Check#: 12.5f- <br /> Date <br /> aDate of staff site visit: 5/6l I Initials of site visit staff:, L . <br /> = <br /> ,E,;_pj <br /> ig-,-, , <br /> APPROVED BY LAND SERVICES OFFICIAL: ,( �//:/ 7 DDATE: 5/70-/ <br /> 'a M 'Ou0 <br /> UPON APPROVAL: APPLICANT DUST POST COPY OF 5.3 <br /> m rfO <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0= N <br /> a,,,4. N Q <br /> Transcendent: - Page 1 of 4 <br /> Laserfische: Burnett County,WI Land Use Application—Rev 12/2020 LL _.).) <br /> a <br /> x <br />