Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line 0 c <br /> Permit Types and Fees:(Please,check appropriate boxes) °- <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> d <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 \0 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 q <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 e <br /> J <br /> Filling/Grading $150 Boathouse $500 o tJ <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 r <br /> r <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. 2. ()3 <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. $ ] <br /> v <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ro <br /> r ?. <br /> Property Owner's Name: O Lane Sitio ViO'A o z <br /> Property Owner's Mailing Address: G it 0 /4w i ') DQp &u'y 'I ' i ,3 $ o <br /> / ty State Zip $ <br /> Property Site Address: SCtrtite F. <br /> Contact's Telephone Number: 701 LH I_"3!q� o F <br /> Contact's Email: dUgheSilOre6 g S M44 e C O 1' d <br /> Legal Description of Property: (.04- 1 ("'�"1 1` /6 P kii k <br /> N 00 <br /> Section#: va 14 Town#: S ii I N Range#: f ) W Town of: S tl 0 <br /> 5' <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): d.o�9) k -. <br /> Proposed Use of Structure/Addition: (.V.4 J=c e "' <br /> Anticipated Start Date: Cisct f (Home/Cabin;Commercial Business;Bedr om;Deck;etc.) 3 ) f w <br /> Building Contractor: Dajie 5 ii o it' Sewer Installer: 4/ <br /> 1 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY w N <br /> THIS PERMIT 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 r+ <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes, manufactured z N <br /> home additions, and bunkhouses.** 1�1 ) Po <br /> 0 Ce �t`i;rcI SurvN4 p CGS 1"�7 l be Co lAytel <br /> toy io 1 2ort � f liv .4'41571- 4074-4i/ t- • <br /> 040 tie / c -Cl590/7G, 1k by7/I/2oz1, <br /> z Fee Rec: l S(�Q 'Ye,Roil e uwich <br /> Clavicle , o Check#: 1/Q,/, <br /> rn <br /> Date of staff site visit: S120/240 Z/Initials of site visit staff: h/r z <br /> v <br /> cn <br /> APPROVED BY LAND SERVICES OFFICIAL: ,,,...,L_ DATE: S/20021 r <br /> ro <br /> Ifil <br /> UPON APPROVAL: AP ' ICANT MUST POST COPY OF Q. <br /> -.7- <br /> 1,- <br /> n <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT an <br /> c � <br /> Transcendent: - Page 1 of 4 w,a <br /> Laserfische: Burnett County,WI Land Use Application—Rev 12/2020 v <br /> .L._._ <br />