Laserfiche WebLink
- <br /> LAND USE PERMIT APPLICATION -Burnett County, WI k 11. <br /> Applicant Complete All Sections Below This Line 0 N <br /> Permit Type*and Pees:Mean.,check appropriate boxes) <br /> a. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> Commercial/Industrial Structure Vj $300 Addition/Alteration to Commercial/Industrial Structure $200 � <br /> 0 <br /> Accessory Structure(Garage,Shed,etc.).'—$t5O Addition/Alteration to Accessory Structure $150 4 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/',&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 g' N <br /> Filling/Grading $150 Boathouse $500 <br /> _ Permit Extension(1 Year Extension-Allowed Once) $100 w P <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communicatlon!,Towers&Signs require a different application form;see corresponding application,and fees. o C- <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o F <br /> Property Owner's Name: f19.L T' i �1k-(1 I1911►1 C., `Zcti,WIQ <br /> 11 <br /> • <br /> Property Owner's Mailing Address: !1fQs L5 OQy I4i'lt� C_ l t1pct � 4 t tv c sity . ,, <br /> Property Site'Address: • o i'.p O. <br /> Contact's Telephone Number: .i o _3i o -24 o • <br /> Contact's Emil' , j inc°ts WtVj''.M tt( (.10A1 <br /> Legal Description of Property: I c* 11-1-0-c---tile. fq. 1/z o L t. NLI o 735 v <br /> Section#: I, ?' Town#: LIC N Range#: f b W Town of: Oct L\cak P a. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* .. <br /> Tax ID#(1-5,digit number;found on tax statement): 33 7 y o <br /> Proposed Use of1Structur ddition: Scat- as-I°C d <br /> Anticipated Start Date: -\.1U-IAC., 2 02 1 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) '-4 c.J•),, <br /> c <br /> Building Contractor:(9.(. t"Ckt 1rh ,..� Sewer Installer: _ Vv <br /> r-- <br /> AREAJBELQW TBIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIN PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z ". <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY constr4iction taking place for any wellings,dwelling additions,manufactured homes,manufactured <br /> home addidpnr,and bunkhouse . * <br /> eha� U, er�n�'s b� 6/lid?„,, she b►u-� ►�ee� p <br /> n en <br /> Date of staff site visit: .2111)-' Initials of ire visit staff- • ; Fee Rec: <br /> �� t, Check#: 3 aS <br /> APPROVED BY LAND SERVICES OFFICIAL: / �// DATE: <br /> UPON APPROVAL: APPLIC A ►, <br /> MUST POST COPY OF ; g ' [Nil <br /> SIGNED <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z <br /> {MCif w HI <br /> Page 1 of w? <br /> Burnett County, WI Land Use Application—Rev 12/2021 m 12,4 M c <br /> OE <br /> ��----.--�J <br />