Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI b <br /> Applicant Complete All Sections Below This Line a� c - <br /> Permit Types and Fees:(Please,check appropriate boxes) ° 1. <br /> Dwelling/Principal Structure ($100'4 Addition/Alteration to Dwelling/Principal Structure $200 <br /> co <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 1 <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 1 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 p� <br /> P N <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 < <br /> Filling/Grading $150 Boathouse $500 <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 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 /> S I e-V-e_ 5Ll.� JOU"\�'N'l l+2- r -4. v�' <br /> Property Owner's Name: // � ,/ . hid z <br /> Property Owner's Mailing Address: �ao F�)e. 7Tt// Parkoy 1V. 77ijo,Md `.C')'38 0 <br /> Li0 <br /> r g� City State Zip -0 1 v d <br /> Property Site Address: 6.32/ FGot da-j'e- !-fir/✓e 1)an bt(ry t 4J' S`f 83 (� .. <br /> Contact's Telephone Number: 07 ia ) oZ I- — 903 5 U e- o S <br /> Contact's Email: 5U€ 1 5C�M I±Zv2Jcg 9 v iaa I • co v" d 1 <br /> oG✓wIP # w <br /> CD <br /> .-, (4'. ' <br /> Legal Description of Property: J- [J 1,.0-F' 3 0-( (',_SY i tfg31 Vol a7 P027(0 '4 o'7,5-4- <br /> N 'TJ <br /> Section#: 35 Town#: �/ N Range#: `(v td W Town of: 5 155 0 <br /> 5' <br /> (Jo <br /> *Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system propertyPage.* <br /> o <br /> N <br /> Tax ID#(1-5 digit number;found on tax statement): 367 ei 8 <br /> Proposed Use of Structure/Adds ion: C�--1b1 h <br /> e <br /> Anticipated Start Date:-�'B�a/naa�1 ,, (Home/Cabin;Commercial Business;_LBedroom;Deck;etc.) 3 <br /> Building Contractor: l l C-€ C Or U?) lar' Sewer Installer: — 1 — — Y. 44 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY , <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: , VJ <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 bunkho ses. x <br /> Mhce+ iii sc I)Er <br /> op Relit tek+ weds b�roak5 541V al-l9 7 <br /> z Fee Rec:3'0c <br /> ] Check#: 45318 <br /> l� r <br /> I m <br /> Date of staff site visit: /7/2'i Initials of sit visit staff: z <br /> APPROVED BY LAND SERVICES OFFICIAL: '7 /j4?; DATE: ,/! 1//?( rn <br /> < J <br /> UPON APPROVAL: APPLICANT ,:/1 ST POST Crn OPY OF a 0)CO c WEI <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT zoo �, <br /> Transcendent: Page 1 of 4 A C Ps„, <br /> r: <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 3 <br /> rn v _ ("1 <br /> cn <br /> L.C--4.-7J <br /> 4 <br />