Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI <br /> b <br /> Applicant Complete All Sections Below This Line 5' <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> \, <br /> n <br /> Commercial/Industrial Structure $300_ Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200_ Addition/Alteration to Bunkhouse $150 C <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 � <br /> Driveways/&Campground Structures $125_ WI State Statute 59.692(1v)Structures $350 $ 5— <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension Allowed Once) $100 <br /> ° \j E. <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. g <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. Z -Jt"1 <br /> 4 ' <br /> Property Owner's Name: )� Y Q - e(�pG/ o o It <br /> Property Owner's Mailing Address: Po iIDO x 3 N3 �ia�baw Uig 'JP`3d o ' <br /> C City State Zip b 3 <br /> Property Site Address: 63 i 5 6V// A0lie DA/ye D4,y et/ry W z F <br /> Contact's Telephone Number: 6/01- 961 / p , o <br /> a <br /> Contact's Email: JO(I bRec e ill t/S C \C /Y�7r4/ 7. cam d <br /> Legal Description of Property: S('C 36T,v '-11 lig 6 W 00 of E '16'/- V -CV SL`' <br /> Section#:_ 6 Town#: LJ/ N Range#: 16 W Town of: 5'CV/$S <br /> 0 00 <br /> 5 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> Tax ID#(1-5 digit number;found on tax statement): .90 Z-J4!•3 <br /> Proposed Use of Structure/Addition: lR 0 6- • 5Tp 4 V 6 &. . "' <br /> y -3 <br /> Anticipated Start Date: ''t,//1J a 0 94 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o x <br /> e <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: <br /> **The applicant needs to contact their('DC 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 vl <br /> home additions, and bunkhouses.*' Pz <br /> i r�tee-� a II Sc b� - . <br /> o+- co( hu.r/40 bi l'. 1 <br /> , <br /> 1 Fee Rec:)i� <br /> 4 Check#: t 38.E <br /> X1/19/?a ttr <br /> . <br /> o <br /> 4 _ . !, -a/ -(.. -51 I <br /> Date of staff site visit: Initials o site vis't s_.ff: '� <br /> APPROVED BY LAND SERVICES OFFICIAL: 0;,, it,,,,,./4"" DATE: 1.149NI ...,„ ' c; <br /> UPON APPROVAL: APPLICA MUST POST COPY OF <br /> as <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 00 m• <br /> Transcendent: - Page 1 of 4 n © 4 n <br /> Laserfische: Burnett County, WI Land Use Application—Rev 12/2020 n l� c <br /> b <br />