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LAiND USE PERMIT APPLICATION - Burnett County, WI z
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<br /> Permit Types and Fees:(Please,check appropriate boxes) i
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<br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200
<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
<br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150
<br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ` _
<br /> Driveways/&Campground Structures $125 WI State Statute 59,692(1v)Structures $350
<br /> Filling/Grading $150 Boathouse $500 e
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<br /> Permit Extension(1 Year Extension-Allowed Once) $100 : • z
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<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 /> 1*Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc, i Z';
<br /> Property Owner's Name: ' l e 4 e / erw U3' alt 1 /f.E' y rye
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<br /> Property Owner's Mailing Address: 7 7 © 2 - 7 7 7-4- gJr 4,►v..„. 0�)f _ >4 "..1,',,77c,.2 z
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<br /> Property Site Address: 17'8--5 5 04.1 ' f?,,1 r . )e >3 s`7t r.l �/Z' S y.e 4 3 - i?
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<br /> Contact's Telephone Number: 7/.5'7- 3 y 9— 8 8 o v — AZ '/s,,r vry rkt
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<br /> Contact's Email: 4 L e All, Ca f"1 e s . e o m
<br /> Legal Description of Property: --- 3 C 5'k1 ' 4195 I V 2a �2 7 9 (�% w I c
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<br /> Section#: / 6 Town#: .,,3 8 N Range#: 1_,,_____W Town of: A a.- o 11c1-7-c_
<br /> *Attach additional page if neededfor 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): 3 Vo ? 90 .4
<br /> Proposed Use of Structure/Addition: 7''J'C. 1,71 E.
<br /> Anticipated Start Date: •-7- .c n e — 02 2 (!lame/Cabin;Commercial 8uxines,S;Bedroom;neck,'etc.) W
<br /> Building Contractor:iFiS,:7'a. ."12¢ J1.4 Al c Sewer Installer:_ op/'7 ,.„t r. .5:0 l'A/
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<br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW:
<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 l
<br /> home additions,and bunkhons s.**
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<br /> Date of staff site visit: 5//7/�� Initials of site visit t:f* iii--
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<br /> APPROVED BY LAND SERVICES OFFICIAL 1,..,...1 i.�ri DA I E:5 3. ?
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<br /> Burnett County, WI Land Use Application—Rev 12/2021 >' 3 c �'
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