Laserfiche WebLink
LAND USE PERMIT APPLICATION-Burnett County, WI a c <br /> b <br /> Applicant Complete All Sections Below This Line 3 c <br /> Permit Types and Fees:(Please,check appropriate boxes) y o. <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 <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $1500 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 C") <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 -: P , <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 /> Property Owner's Name: L.)CU fj/tib 1 in C.11 Jn t A ° o <br /> Property Owner's Mailing Address: 5`t S )1 L/.14-. L't-n e. Ni 'CC©, Ra k Mrd .S1/3s �' <br /> City State Zip .c <br /> Property Site Address: ag 5 C7 <br /> (p'G Lc -1- j ,n Lqt� <br /> _ rJ,t r-� 4).-2.7-5WQ F.. <br /> Contact's Telephone Number: 116 3 40 3 9 -- _5-cp. J.. o r <br /> i `' . - <br /> Contact's Email: l,t,�I i szIrt 3 1 O U C�% ill l ,c 7)r\; e t t»Lo .(d,I n-c:l e r< I(t le--V\e T o <br /> ! a IL. <br /> Legal Description of Property: L..C`,--I,• J .)-- ‘ <br /> t , ao <br /> Section#: t-1 Town#: l 0, N Range#: / W Town of: jI A _t., r; u , , • ;; ,`,4 o. <br /> *Attach additional page if needed Ibr lengthy description OR attach a copy of the deed OR attach tax system property page.* U. <br /> Et <br /> Tax ID#(1-5 digit number; found on tax statement): L1 t <br /> Proposed Use of Structure/Addition: S 1-C C <br /> cf;Anticipated Start Date: ,S.ap{- H <br /> p Z Q I (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> o 0 <br /> Building Contractor: M eA-.y L._Q ,elf ek.,, / ,r- Sewer Installer: / A <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 r' <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** 004—�f ��� J (,��� �o <br /> V Oi 41l (� (tq LU 1 <br /> 0 CAtiler nee4S CO b , i24/P4 orPern <br /> 419 b <br /> O Gr0. o & ¢,y► ,�y� 1 rpt / — <br /> e•��p� /'i"`t� be V s Fee Rec: 1 �� <br /> 4.4 P let <br /> (/ Check#: 3 444_, <br /> 0 <br /> rn <br /> Date of staff site visit: $/3/ 0.../ Initials of ite visit staff: ./ „air a [�] <br /> APPROVED BY LAND SERVICES OFFICIAL: ilk�., iffl <br /> � d��� CI/82 l 7 r- <br /> � DATE: < m <br /> c <br /> UPON APPROVAL: APPLICAN UST POST COPY OF w W 0 <br /> me v, <br /> T n'a, Cti <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT c2 U)a) • oIM <br /> ., g2 N o <br /> Transcendent: Page 1 of 4 r-1 ..) Q <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 <br /> m <br /> cn <br /> > , ...66.......)j <br /> 3 <br /> .9 <br /> I <br />