Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> Applicant Complete All Sections Below This Line 5� LAN <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> / Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 t <br /> \)v_t <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 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250il <br /> ) <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 a .sb IP <br /> Filling/Grading $150 Boathouse $500 up <br /> D, <br /> Permit Extension(1 Year Extension-Allowed Once) $100 k. <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. �' I <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. �, o !. <br /> III <br /> Property Owner's Name: ,`)J)Lt1)i 1C I l N . r)1 t Eik I 1 Q. <br /> Property Owner's Mailing Address: 14(.'11 l)).5i 131)) I?r,ici t /i l�)I)kbu 1 l'h 2 548�-F i fl4 <br /> 7`)J City State Zip c <br /> Property Site Address: (q t,'i 1-. 731",f 1,41)) "i( .i i (j I,. i-1 C}b i i I Cj i LC�1 ri43�L a <br /> e <br /> Contact's Telephone Number: ri iy 1) 4�W1 (i,CI-;I <br /> ro <br /> Contact's Email: 3 ha ii i'rr) ill b 1 l'r:)i'ii Pi- ir i I , 3 il; o� <br /> Legal Description of Property: ki;t 0.3 il f kI t 4S 4'1 \41 f 1 i.I %-r6` A h' tk 45.5 13 1 d <br /> Section#: a 9 Town#: 3 ci N Range#: 1 q W Town of: -hi?St }-�)f c i 1i l,.)p<J <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): 35 13fi _ <br /> Proposed Use of Structure/Addition: kitme, -- ..11 <br /> Anticipated Start Date: ''G // ‘,71,i,,j (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) -i l/" <br /> !,- Sewer Installer: + <br /> Building Contractor: f111r. -,U <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY IPI <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> pz <br /> i.VY construction taking Mace for any dwellings.#welling additions.manufactured homes.manutacturea <br /> l Se k b(4-0443 <br /> l Pei/ 5�1 U-� -�3,��pwe((, ✓jof G-eea 3 bedjO64 Fee Rec:?(. j�—, <br /> • Check#: 2&/9 <br /> 5/3/a� L <br /> m <br /> Date of staff site visit: Initials of site visit staff: y <br /> If z <br /> d CID <br /> APPROVED BY LAND SERVICES OFFICIAL: i ,07DATE: 5/6/2-0) rri <br /> • r <br /> . Q <br /> UPON APPROVAL: APPLICANT UST POST COPY OF m E` 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT oMI 1.1 <br /> Ft CC.Page lof5 :':1*. tvv <br /> Burnett County, WI Land Use Application—Rev 12/2021 ' <br /> b <br />