Laserfiche WebLink
LAND USE PERMIT APPLICATION Burnett County, WI a <br /> - <br /> . b <br /> Applicant Complete All Sections Below This Line 6 <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 /> rCommercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 f�f Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 �JAccessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250G� ri3,,.. .�, <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° pVFilling/Grading $150 Boathouse $500 r» J •0Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 i� <br /> c <br /> *NOTE:After-the-fact permits(permit aqui red 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 /> CD <br /> Property Owner's Name: R6'^q\ \Q•1 Z. ° z <br /> 0 <br /> 1 <br /> Property Owner's Mailing Address: /G S- Si, f� , 3 S ...b5 ' ''L Sygg3 : N <br /> _ <br /> �� \ City State Zip a. <br /> S ` <br /> Property Site Address: ( R. DavAsK4t'� wi, 6' n <br /> !' <br /> Contact's Telephone Number: 1 1-S- - S(r. Co SD°\ o N <br /> 1 <br /> Contact's Email: J`'\\\e '\c\v`'L Gyy C� ',l°AvA-u•1\. 0 W\ <br /> C d <br /> Legal Description of Property: SE S <br /> N <br /> ` <br /> Section#: l\ Town#: y6 N Range#: 1 b W Town of: 61<:‘ 'N e\V\.a = crc. <br /> *Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system propertypage.* <br /> q <br /> Tax ID#(1-5 digit number; found on tax statement): 1-3\18 <br /> Proposed Use of Structure/Addition: Po\e_ b o,C <br /> Anticipated Start Date: AS A P (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) t�1 x <br /> / <br /> Building Contractor: v 0 Ne Sewer Installer: 1 /0� -� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY A <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 a <br /> home additions and bunkhouses.**00 (fe�-all 5e---b41S <br /> ei No4 LerK n IA41 bd4-d <br /> Fee Rec: 1513€ <br /> 4 Check#: C, S.H-- <br /> a�12-! v <br /> 9 � <br /> Date of staff site visit: Initials of ite visit staf r <br /> / r T30/c4 • ' —� C� <br /> APPROVED BY LAND SERVICES OFFICIAL: p DATE: I/J O`► <br /> UPON APPROVAL: APPLICA y,'//' <br /> UST POST COPY OF CO W 0 <br /> Tn.CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ..... C <br /> Transcendent: - Page 1 of 4 ifil <br /> 1 -- <br /> -- <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 .1511 <br /> -,• L J <br /> • 4 <br />