Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 0. cnN <br /> Permit Types and Fees:(Please,check appropriate boxes) 4 .- d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 V U` <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 t)v g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> X Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 FI <br /> tk <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 ),, 11 <br /> Filling/Grading $150 Boathouse $500 N <br /> Permit Extension(1 Year Extension-Allowed Once) $100 0. lb <br /> 1 <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. o <br /> 6. <br /> Property Owner's Name: r e L(L° v k. C(G -- �°a <br /> Property Owner's Mailing Address: Ra✓l G L 0 A {�C((n e., C- tet ( ` !V 7 <br /> (1City State Zip o <br /> Property Site Address: 011- ck S 10 -f�1-Z(� l Lt/� '1� l . i <br /> Contact's Telephone Number: —7 Cr" 6 l S —0E 7 z d <br /> CD <br /> Contact's Email: pa I ez 6e",d-0 �li(G!it L CO wt .. <br /> C' \ r f I I � °° <br /> Legal Description of Property: PGI v Z �,1,1 C(,L,>tt (4j 4l Z <br /> '/1 (,�� �L <br /> Section#: 1J Town#: l" N Range#: IL,/ W Town of: -c '6. <br /> n <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): ff yes L I <br /> a <br /> Proposed Use of Structure/Addition: �'� <br /> Anticipated Start Date: Q y (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) V <br /> Building Contractor: PU l l ) d- Sewer Installer: G <br /> A, <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 bunkhouses.* <br /> 0, eek aU se.- ci <br /> S <br /> z Fee Rec: ,, -1. <br /> y Check#: /9 <br /> Q o <br /> Date of staff site visit: 5/1 I (79 Initials site vi it s :ff: i" m <br /> - 0 <br /> APPROVED BY LAND SERVICES OFFICIAL: 1 p� DATE: 5h,�/p y <br /> RI <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 1 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> O <br /> ; <br /> Page 1 of 5 ` IV <br /> Burnett County, WI Land Use Application-Rev 12/2021 '�' - U� <br /> i <br />