Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI c <br /> Applicant Complete All Sections Below This Line c rN-, <br /> Permit Types and Fees:(Please,check appropriate boxes) n' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 9r <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 1 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures _$125 WI State Statute 59.692(ly)Structures $350 ° <br /> Fo` <br /> Filling/Grading $150 Boathouse $500 -r N K <br /> o ^%. <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <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 /> rR 11) <br /> Property Owner's Name: 120k A-Nb ti A-IL; Y (i A7 } ° z <br /> Property Owner's Mailing Address: 2 8 8 g q 8 c L)c t 4.-/A--1-c. " /2 c'- L o 111 <br /> City State Zip $ Ili <br /> Property Site Address: .2 g g g 7 al-0 sc- t-i -ic /24, i.DA-+d15v 2'( /.tel S 'f`3" F. n ti <br /> c 1 <br /> Contact's Telephone Number: ,72 I F- 3 ci 2 - 5 7.2 <br /> o c , <br /> Contact's Email: j') e_,,, in .-I— 0 i o q /` S' y/)--fes L, , c e'/'`, d <br /> CD <br /> Legal Description of Property: G 0 J , 4_07-s 6 Vii-)0 R .. <br /> 9 oo oc <br /> Section#: Town#: y© N Range#: l ? W Town of: v N/ O _ <br /> c. <br /> a` <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system roPert3Pa e.* <br /> d <br /> Tax ID#(1-5 digit number; found on tax statement): 11 5.9 I <br /> Proposed Use of Structure/Addition: 1-;* /t tZI e" cn <br /> Anticipated Start Date: t) i.._/ (Home/Cabin,,Commercial Business;Bedroom;Deck;etc.) x <br /> d <br /> Building Contractor: 0‘-.'c/�(C J2 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 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 bhouses.** 7: <br /> co ,,,tio, cel( Condi'-h.011S PLA-l- -fix-\4i o't <br /> ® �vl(0v4-) aII bLA;la4 J -- 5e+bac k P <br /> icAs <br /> z Fee Rec:35 Y <br /> 4 Check#: 573(.0 <br /> o 6 f'71d- 1 o ite visitf — m -/ itI.an pski,ni <br /> Date of staff site visit: Initials staff: ,/ a <br /> APPROVED BY LAND SERVICES OFFICIAL: ,/,, DATE: 6//e3/011 <br /> f 1 g :,---,, <br /> l'-'''".. . <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT i , <br /> Transcendent: - Page 1 of 4 V <br /> Laserfische: - Burnett County, WI Land Use Application-Rev 12/2020 <br />