Laserfiche WebLink
LAND USE PERMIT APPLICATION —Burnett County, WI a <br /> s b <br /> Applicant Complete All Sections Below This Line a N <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) v U-1 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 S <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p <br /> )< Accessory Structure(Garage,Shed,etc.)l1.5 X58 Addition/Alteration to Accessory Structure $150 )1..) ;. <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 Q <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <<. <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 E ? <br /> Filling/Grading $150 ' Boathouse $500 v) 7-1 <br /> Permit Extension(1 Year Extension-Allowed Once) $100 ' <br /> *NOTE:After-the-fact permits(permit squired 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. r 0 --C0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: ( r✓1r�2 � 4 L 1Y�� In <br /> (' - <br /> Property Owner's Mailing Address: l li 1�yMc,r E `) <br /> City State Zip c <br /> PropertySite Address: 3 5 5r1y xL � Jetl <br /> g V; <br /> L`0-`� <br /> Contact's Telephone Number: 115. w <br /> a., &S 6— S� ` e <br /> ' <br /> Contact's Email: 4-%- i`1'i - is 1 Ci_ c4\ I r,60 904et. I • c.5.:A.4,--. o <br /> Legal Description of Property: 5 1/2, SE Mvvao <br /> P. <br /> Section#: C Town#: qD N Range#: E 7 W Town of: Utit c c,;r . <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> c4Q <br /> Tax ID#(1-5 digit number; found on tax statement): • 4? 31 <br /> i - v 1 u <br /> Proposed Use of Structure/Addition: 5 cc,-'t yl� ex- �l (truer- 44,..r, c 1.yip'am:.n <br /> Anticipated Start Date: ( (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: 1((ALL( &vim.Q.�?: k`F' Sewer Installer: r- <br /> t <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY �. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: po <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 <br /> home additions,and bunkho ses.** <br /> Oise* 411 $e{-Lo` Q 0j04 kw,1 �b,4- /04. <br /> go A!1 $#r4chAr�2s + ern ferd.S.3 s.^✓ •�,5 oat r oast-CI— neeciQe,�al-5 L�4 <br /> 6045 teteea C uP or be r{1/11)/ 6111)?... 6/1 I?2 P ) x <br /> oo <br /> Date of staff site visit: 1/2•2-�� Initials o site vis t st <br /> Fee Re ? J <br /> / o Check#:2. 7(,,, <br /> 7y <br /> APPROVED BY LAND SERVICES OFFICIAL: a �, DATE: 3biaa- <br /> 'n <br /> UPON APPROVAL: APPLICANTMUST POST COPY OF a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT rn re-- <br /> 11 a W N <br /> 6 • _. N <br /> S o <br /> Page l of oc o �' mC <br /> Burnett County, WI Land Use Application—Rev 12/2021 < F N C <br /> rr,X 3� N <br /> EA m <br /> b <br />