Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) k -3 <br /> K' Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200w• 0 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200\ v .— <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> f <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 g <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> G] <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o <br /> Filling/Grading $150 Boathouse $500 r <br /> o <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100cip <br /> AD <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. $ i <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. - ro <br /> Property Owner's Name: t�ef'/A d Me/Ikea_a /e_#t C.-.0"- z <br /> .) <br /> Property Owner's Mailing Address: 12Z5- P er c -- 'Pat j -< tti� 5Ye0/ o <br /> -^- , i City State Zip <br /> Property Site Address:I)4'3 9erktirSe2r) ] rat u <br /> E <br /> Contact's Telephone Number: 612-Z'f e Z6 2 o l\� <br /> co <br /> Contact's Email: erfh it-/CC�., 6�l 3-in tt'( +CoU t"vim o �a. • <br /> L2)—g'Legal Description of Property: P� CD <br /> .�.- Q <br /> Section#: ( 3 Town#: If N Range#: W Town of: —,C O 0 °0 <br /> t <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C7 <br /> Tax ID#(1-5 digit number; found on tax statement): 3 3 -2 g ,_, <br /> ,. <br /> Proposed Use of Structure/Addition: c" <br /> Anticipated Start Date: Q et Z 9 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) f k <br /> Building Contractor: .5e1' Sewer Installer: ittLeettOs S/Ad dot— Lj eklitL —_ <br /> H 'J <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY n <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 ii, <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured z <br /> home additions, and bunkhouses.** z <br /> (1 ee-- all v�� C �o4 1+4, !o side ! - G"ne, <br /> 16+41,0a:41 y 7'S 4a w�'�, <br /> DA•e�G ��- ehz aS <br /> Per Mg-W-01 ( 3s <br /> d li <br /> ()ivd �;Ii Wtivn e�' z FeeRec: 30f�. <br /> J 4 Check#: 74"23 <br /> 0 <br /> rri <br /> Date of staff site visit: .Ord&?( Initials of s' visit:ff: '' _ z <br /> Is <br /> APPROVED BY LAND SERVICES OFFICIAL: . i ,,,Oirr' DATE: l/I5/ Fg <br /> UPON APPROVAL: APPLICA UST POST COPY OF = UuU <br /> SIGNED PERMIT APPLIC • TION IN PLAIN SIGHT m , ^ Guy <br /> a = cr=1 <br /> Transcendent: - Page 1 of 4 m -: o <br /> Laserfische: - Burnett County, WI Land Use Application-Rev 12/2020 g < -- <br />