Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a C <br /> b <br /> Applicant Complete All Sections Below This Line ° c.• <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> ,,, * <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p/� <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 � <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 .- <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° Q t <br /> Filling/Grading $150 Boathouse $500 r- X <br /> 9 <br /> Six Month Camping Unit(One Per Year) $100 )( Permit Extension(1Year Extension-Allowed Once) $100 <br /> 7 <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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> n L.,U-P -Z•- 1 )rf r g �' <br /> Property Owner's Name: e`e,,,,,„ n o PL d'4' o <br /> Property Owner's Mailing Address: t7 (,I p g/ f�✓ o <br /> n _City State Zip <br /> Property Site Address: 1 f Q 0-- pp� � jp 6 , ,Y!�,��' �j c n <br /> Contact's Telephone Number: ?1.I- '6(:).---W 3 D 3 o•_ c <br /> F° <br /> Contact's Email: j1 ertvt 1 ieff @ i� 'SLa?E, nej d <br /> �' <br /> Legal Description of Property: ' c - ' i, . All <br /> (1 .tt UI pi/ Q•sl ,�3// N b <br /> �•� I 0 = °G <br /> Section#: is Town#: 3q N Range#: , W Town of: - <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> 4. <br /> Tax ID#(1-5 digit number; found on tax statement): I I (22 riti. s. <br /> Proposed Use of Structure/Addition: 146t O& ,S- c (c ,U1 <br /> Anticipated Start Date: losf (Home/ in;Commercial Business;Bedroom;Deck;etc.) <br /> n ) x <br /> Building Contractor: /V0rf( . 8t,�r�./S Sewer Installer: /11/1Ar <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: G <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to 0 '`...1 <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured z i • . <br /> home additions and bunkhouses.*,* ��11) <br /> 'mak . , t i��,tfY�r�+'� ?eret4 - <br /> V4or �O`�dcrDc`t�e <br /> lit N, - <br /> 1,44 v5e- <br /> ,? <br /> oi -, )D al IPA <br /> /21 n "-r% <br /> zFee Rec: <br /> LCheck#: 7(,/5— <br /> Date of staff site visit:a lo( ?1 Initials of s' e visit staff: i � <br /> Z <br /> , <br /> _ �, <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: Oil 3I?/ <br /> N �f <br /> UPON APPROVAL: APPLICAN - UST POST COPY OF 1.; G <br /> fillSIGNED PERMIT APPLICATION IN PLAIN SIGHT to , o <br /> a c3 <br /> Transcendent: - Page 1 of 4 12•'` ry <br /> Laserfische: <br /> Burnett County, WI Land Use Application—Rev 12/2020 _ _NO <br /> m BUJ0 <br /> ..j <br /> 3 <br /> -a <br />