Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line 5. c <br /> Q. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> d :..k <br /> Dwelling/Principal Structure $300 x Addition/Alteration to Dwelling/Principal Structure $200 <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 a <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 (r <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° 11 <br /> Filling/Grading $150 Boathouse $500 r- <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. r C.. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: \ ��` `�1 , lir 0 `I' CD h,...-„,' <br /> o z 3 <br /> 1,_ 9Property Owner's Mailing Address: [0 % 3 W \ r <br /> i r � City State Zip o <br /> Property Site Address: 7? 1 i \4 y" jU —�F'ticaT —.3 <br /> ?ts ->>3 �`.73eD cam, \ Imo,$ 1� 0 <br /> Contact's Telephone Number ;;a\.,�1 733 z� ' 4Z q\ <,,, —lir W5 116 7 o c <br /> Q �^ n � 1 a I, <br /> Contact's Email: �'� ,�1% ` Q� SL�1ti 1 1` -j k . ,h). ;CI , <br /> Legal Description of Property:_ / S 4 :`V I 1 a,7)• CO 4 <br /> ) V 4`e 14:j- <br /> N <br /> c <br /> Section#:O E Town#: �U N Range#: / W Town of: cAk � a <br /> 5. u <br /> *Attach additional page i needed or lengthy description OR attach a copyofthe deed OR attach tax system property page.* <br /> * "� <br /> PS l f g Y P ]� Y P P hPS ' . <br /> Tax ID#(1-5 digit number;found on tax statement): ) 7-7 7 <br /> Proposed Use of Structure/Addition: c2_)-12- 'N' 141 \ `in <br /> Anticipated Start Date: 7 6--„A--„A�7 l (Home/1 abin;Commercial Busine s;Bedroom;Deck;etc.) J a 0 X <br /> a d <br /> Building Contractor: Sewer Installer:' 0 S <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: e� ,V) <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 addi 'ons,and b1unkhouses.** V N `P.1 , <br /> � 1 7 <br /> A_�"1 �C e e �ca 1 UN <br /> m o2-' 4.U Sof&c-itg <br /> z Fee Rec:IcZO <br /> FAv <br /> Check#:ech <br /> m <br /> Date of staff site visit:7/7/a( Initials of site visit sit - , <br /> APPROVED BY LAND SERVICES OFFICIAL: 4 7/f;!?! <br /> � DATE: < � <br /> , N <br /> UPON APPROVAL: APPLICANT 'i ST POST COPY OF Nco c C <br /> 13 z <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z till.%e, 4.0 <br /> N C o <br /> Transcendent: Page 1 of 4 m w N <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 < m g <br /> rr,0 <br /> a L...� <br /> 3 <br />