Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> y <br /> Applicant Complete All Sections Below This Line co N <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 2 C) <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 V(JI o <br /> \ & <br /> x Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 -.0 �, <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ,- <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° G <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r <br /> Filling/Grading $150 Boathouse $500 <br /> 1. <br /> Permit Extension(1 Year Extension-Allowed Once) $100 <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. t <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o 0 r <br /> Property Owner's Name: 1'12-1AIJ ri-A u <br /> n. <br /> Property Owner's Mailing Address: 1 y10 1 t 1"( P %pookk W ) ► )1` - '' <br /> 5. City State Zip c N <br /> Property Site Address: �ifiYp to <br /> a <br /> Contact's Telephone Number: /0'7' -71I - b',42,1 Fp <br /> Fp <br /> 1 Vnn � `� <br /> Contact's Email: 11.-• GOA-0�2�-1C,1'1r GE-MA- iL• ( 0 I• N e <br /> 0 00 <br /> 0 <br /> Legal Description of Property: J lel Y4 b F )s'1 /4, AoV_ L.,-,-- 1 d <br /> Section#: 7,10 Town#: 40 N Range#: (4 W Town of: ' C-C-1"1- 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): I.-1 i 1 <br /> Proposed Use of Structure/Addition: OA F-'L� {- � r <br /> Anticipated Start Date: + (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) = Di <br /> -TOM -(; <br /> Contractor: � L1IDG�ILj� Sewer Installer: �D�}f �Ul.l�ld 1& <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: x <br /> X.. <br /> tt€ ,,i;,,,_,. ,. :E2::!,,!.,,.?. .,Pf.,.Lc. .,.eSL _y..'t_. it..+ps c...:r 'ab tti Lies•..,.e1 s.' f f, ti a..,.e<< ., r:_ z ji';5,i. .,Z£.€gid price o. <br /> ANY construction taking place far any dwellings,dwelling additions,manufactured homes, manufactured <br /> l : additions, and hurt/tltouses. <br /> ll 5 b4 Sklecytk <br /> 164 <br /> 1 <br /> an v4b fivesi�`� Dt <br /> i i x Fee Rec: <br /> L D3 Check#: )15:33' <br /> tn <br /> Date of staff site visit: 4 1 Xe7l d-O' Initials of 'te visit s : , <br /> APPROVED BY LAND SERVICES OFFICIAL: �� DATE: M <br /> / a <br /> UPON APPROVAL: APPLICANT UST POST COPY OF : W 3 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT '0 o <br /> ' N <br /> a <br /> V <br /> Page l of 5 '3 'nw <br /> Burnett County,WI Land Use Application—Rev 12/2021 . <br />