Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> T is4 <br /> Applicant Complete All Sections Below This Line s' G <br /> pP P = cO , <br /> Permit Types and Fees:(Please,check appropriate boxes) .. n rt. <br /> Dwelling/Principal Structure $300 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 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °e Z <br /> Filling/Grading $150 Boathouse $500 r Ill <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(l Year Extension-Allowed Once) $100 N <br /> cip <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. w <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. 3 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. - «hj-. <br /> Property Owner's Name: a go LS 4. )--yrt h U n 9z <br /> Property Owner's MailingAddress: V' , so sJite N o <br /> , ? <br /> -�,C,it tate Zip/ <br /> Property Site Address: mato .6*`�elfi-cd C , wl E--. <br /> C <br /> i <br /> Contact's Telephone Number: 763 -3 7 / —5p2 Lc C row o 7 <br /> c <br /> ii <br /> Vow a <br /> Contact's Email: 9.137-1.1,t C 7,/� e,oI-31f C a-� - j1 e,� d <br /> Legal Description of Property: el 't i f t,4 Pb' 1ii <br /> i-- o <br /> N 'v <br /> Section#: Town#: N Range#: W Town of: = °` <br /> 5' <br /> circ*Attach additional page if needed for lengthy description OR attach a copy othe deed OR attach tax system propertyPaSe.* <br /> p <br /> Tax ID#(1-5 digit number;found on tax statement): r <br /> Proposed Use of Structure/Addition: Yo o `2 v) <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) IV IP ox <br /> Building Contractor: _�t Sewer Installer: O tk 10, .74. <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, nd bunkhouses,** <br /> i '(eek. OdSe-tb ,ermA- of (e5 7/v)??- <br /> s Fee Rec:3U6 <br /> o <br /> Check#: loa j,3 <br /> Date of staff site visit: 7/R 1/2"I Initials of site visit staff. . z <br /> APPROVED BY LAND SERVICES OFFICIAL: 2�,� // ��� DATE:7I�Vi�/ --'�=--' <br /> 1511 <br /> UPON APPROVAL: APPLICA '" <br /> > MUST POST COPY OF <br /> 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT (t`� <br /> o <br /> Transcendent: - Page 1 of 4 z N /� <br /> Burnett County, WI Land Use Application —Rev 12/2020 ��7I <br /> Laserfische: gill <br />