Laserfiche WebLink
• <br /> LAND USE PERMIT APPLICATION—Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line = N <br /> Permit Types and Fees:(Please,check appropriate boxes) >' a p <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 i N <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 �\ <br /> K Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 j ` ill <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 I <br /> o /, I L_ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ' <_ 9 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 1 <br /> Filling/Grading $150 Boathouse $500 I� <br /> Permit Extension(1Year Extension-Allowed Once) $100 <br /> I <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. <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 1o <br /> Property Owner's Name: Clad*-1-0K4 jr at/ i &4i- PN VV ipe— l� `TTr 440.. E. <br /> U 16 <br /> Prope Owner's Mailing Address: 87& UAtY 1S /4Pu� i,J MN 359 <br /> E <br /> ,,,, City State Zip C <br /> Property Site Address: _Z-33// 1/i-riIfK l ,° <br /> " a <br /> Contact's Telephone Number: /l_ 7/4-612-1. d --\ <br /> Contact's Email: rilyi.z, (Ale,' 4r-01 0 'FM/I- -ler/1 el.net N b <br /> a °G <br /> Legal Description of Property: 5ef- /1 <br /> T 38 911 NW' . .5 <br /> Section#: 19' Town#: 3g N Range#: 17 /4 WSI own of: p"-Ale%I5 . <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* I c4 <br /> I <br /> Tax ID#(1-5 digit number;found on tax statement): Z317,c� o �J C) -) i � , <br /> Proposed Use of Structure/Addition: (a.r�� I I <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) , <br /> ,..), <br /> Building Contractor: 51,-IF Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY { 'ft W <br /> THIS 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 construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured <br /> home additions, and t unkhou ** <br /> 4 <br /> £3cc& <br /> ail <br /> r k , h 't1 �� !�Fee Rec: <br /> M <br /> 51 Check#: i-ttlin <br /> G /1 k/Z- <br /> Initials Date of staff site visit:5/3/ of s'te visit s j : 01 <br /> 01 <br /> / / 6 , J . <br /> APPROVED BY LAND SERVICES OFFICIAL: / - DATE:.5/ )(2? <br /> 7g <br /> UPON APPROVAL: APPLICANT 'ST POST COPY OFn <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 ^, <br /> 71 <br /> 2 N fill <br /> Page 1 of 5 1%.1 <br /> NV <br /> Burnett County, WI Land Use Application—Rev 12/2021 — , <br />