Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett Counts', \\'I a b <br /> Applicant Complete All Sections Below This Line _ c t� <br /> Permit Types and Fees:(Please,check appropriate boxes) ° L <br /> en <br /> o (1)Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 1 .) <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 c� <br /> g E (-- <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °. • <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 I` <br /> Filling/Grading $150 Boathouse $500 <br /> v <br /> Permit Extension(1Year Extension-Allowed Once) $100 <br /> v. <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> CD <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. o <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> o <br /> 0 <br /> Property Owner's Name: ✓0)�el,‘ 4.. ,) ,,,,14.. ,) ,,,t1 -35.-�/a� <br /> ET <br /> Property Owner's Mailing Address: �� 1C k I,°� CI <br /> x\- 3 .-&(-6.-•• sc Lv� City State Zip o <br /> Property Site Address: V ncf �gd( •- ,, <br /> 1 n. <br /> Contact's Telephone Number: 414 303 I(PCI7 0 <br /> en <br /> Contact's Email: _YvInb.JN1,ay.12 N,Coo` N -o <br /> Legal Description of Property: r\i..\-6(Lktse .� <br /> u <br /> Section#: ___ Town#: 02� N Range#: W Town of: C ��� <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 1 v, "Zi) <br /> c <br /> 1 L0.7---79 <br /> Tax ID#(1-5 digit number;found on tax statement): 1 n <br /> Proposed Use of Structure/Addition: J`-L- ° <br /> Anticipated Start Date: _ (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> �� cr <br /> Building Contractor: Sewer Installer: Ic�11 4...) <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <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 bun houses. <br /> 1 Mee- all Set <br /> O ll A0-1 ,e 40 q WI cern, per SAN- -?2- 66 2 Fee Rec:� boo <br /> IP 11.4# i�(,ST yeing rt 4p 5eroG� 44E. betriitheaS-Q- Check#: LDQi <br /> ` / o <br /> Date of staff site visit: J/Li/3.9— Initials o site vi 't (� m <br /> A i r// A/ 7 <br /> C <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 5(0-1 d <br /> UPON APPROVAL: APPLICAN UST POST COPY OF m t: , <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o 00 y <br /> z do O <br /> -< '0 3 N <br /> C°4-C.' Iv <br /> Page lof5 m <br /> Burnett County, WI Land Use Application —Rev 12/2021 < 3 <br /> m �1 <br /> C l` -/J <br /> Cn <br /> J <br /> a <br />