Laserfiche WebLink
LAND USE PERMIT APPLICATION-Burnett County, WI a b <br /> ti tJ <br /> Applicant Complete All Sections Below This Line °, F. ;r <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 g _9 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 Su <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 p 3 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 QT g <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 � <br /> Filling/Grading $150 Boathouse $500 t. n <br /> 0 • <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 — 7V <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. F <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. m 0-- <br /> s i. <br /> Property Owner's Name: r fir 1 () U (7.3--- J/I ij Ql Y `� f r o <br /> 2 g l0 jewel in P/ImD L4h n,^j J 447 I_ ) y -� <br /> Property Owner's Mailing Addres G. 'Ob r I r cin 15 l(A n e/ Lo l r al $ 4-• <br /> City State Zip ro <br /> Property Site Address: "o <br /> /-2 1 p E <br /> Contact's TelephoneNumber:1 -'337-I17O cC\\ (mr.L.ri IQvZ-770 - I5Y-0 o --� A . . n a. <br /> Contact's Email: KO, r'V `O i'") e Y' of -. O i7\ X --- � o <br /> Legal Description of Property: P d 4 o— La-- ,/ C-S rn V f I p 17?' v <br /> Section#: `TI 1 <br /> q Town#: N Range#: if W Town of: .3 C ° �j <br /> 3' <br /> *Attach additionalpage i needed or lengthy description OR attach a copyofthe deed OR attach taxsystem propertypage.* o0 <br /> .f� .f St Y PaB d <br /> i <br /> Tax ID#(1-5 digit number;found on tax statement): I4z6 (Si Z <br /> Proposed Use of Structure/Addition: r 0. d1_ ' <br /> Anticipated Start Date: CCA-Ank; \ tn56I (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) , . i -- <br /> g Si,' S Q� 0 <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 0 <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 /> fie& & 54.,b jits <br /> gb <br /> Nal- &7 1(kvimA r k4 l -�v�1 <br /> iFee Rec: <br /> 5 Check#:-§� <br /> t(21d ?i <br /> Date of staff site visit: Initis o site vis' staff: 't <br /> APPROVED BY LAND SERVICES OFFICIAL: / ATE: 100-I /4 I QJ <br /> i <br /> UPON APPROVAL: APPLICA 'MUST POST COPY OF 4 i Guy <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 fl ' <br /> Transcendent: Page 1 of 4 A c"' <br /> Burnett County,WI Land Use Application—Rev 12/2020 2 Q <br /> Laserfische: v <br /> 6 <br />