Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WIf <br /> a ro <br /> Applicant Complete All Sections Below This Line F o. N i' <br /> Permit Types and Fees:(Please,check appropriate boxes)' c 6 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 \ d 01 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 " _j 1 <br /> Accessory Structure(Garage,Shed,etc.) $150 Vi Addition/Alteration to Accessory Structure $150 .. O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 W <br /> xDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250. <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $5006 <br /> o :� <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> c. <br /> *NOTE:After-the-factpermits CA ," <br /> (permit squired after construction has begun)may cost up to three times the normal fee. P <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. ,y I <br /> o A <br /> Property Owner's Name: ,teitiE 6t�� �' z <br /> Property Owner's Mailing Address: 72* /lifls .A1 I'fg[.Lo SGT fri J1,ilikJ� rf/J SS(I 2 0 011 <br /> •1 City State Zip <br /> Property Site Address: ( 2 S# J L - SI-424.-"T. • r,C IV el3S77iz 4/1 5 it 1713 - n <br /> c <br /> Contact's Telephone Number: 71 S.-- '(7— b2-2I o - Ill <br /> a <br /> Contact's Email: gi T Q 1/E-Wit_4-4).,..1C1 <br /> Legal Description of Property: $4.14 L M,tip' C�.,L , (_—o-r 5 ' (s <br /> Section#: 44 Town#: '3 2 N Range#: 1 5 W Town of: L Pc c <br /> L-LeD � �' <br /> k ° w <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 00 <br /> Tax ID#(1-5 digit number; found on tax statement): 10 2S'(o a• <br /> Proposed Use of Structure/Addition: Si";. S( de c,_) _ ( K r <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o k <br /> F <br /> Building Contractor: Pc'j fi(_ Lo,.,foto,1 (a„JV' Sewer Installer: .Er—r— Fi7X, t7 <br /> AREA BELOW THIS LINE FOR LAND SER CES STAFF COMMENTS/CONDITIONS ONLY f_ Q <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,and bunkhouses.** \ <br /> 1412 hal Not )( k,t1 " k , d'' <br /> ✓71ee-4-- 411 seb# <br /> Fee Rec: e 757) <br /> CIS <br /> / / c Check#:-Z <br /> Date of staff site visit: blll/ 2 I' Initials of ' e visit taff: f �� <br /> � , , z <br /> . <br /> APPROVED BY LAND SERVICES OFFICIAL: A / ��'�DATE:L6//3/ ?/ ��-.-� <br /> m �1 <br /> UPON APPROVAL: APPLIC • ����UST POST COPY OF �uU <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT • 5• <br /> 0 Zi r iil <br /> Transcendent: - Page 1 of 4 m z p <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/20203 <br /> . <br /> LTJ <br />