Laserfiche WebLink
C4 ;17 tl <br /> LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 3' <br /> Per it Types and Fees:(Please,check appropriate)? xes) a <br /> Dwelling/Principal Structure ( $300 Addition/Alteration to Dwelling/Principal Structure $200 O <br /> ° <br /> Commercial/Industrial Structure 00 Addition/Alteration to Commercial/Industrial Structure $200 <br /> tcesSIIrVs fucture(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 . O <br /> F <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 � <br /> •I Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> /N <br /> Dyi eys/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 ° <br /> Fitting/Grading $150 Boathouse $500 t- <br /> o <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(l Year Extension-Allowed Once) $100 <br /> c <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. a <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. C--. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. .1:1 ; <br /> Property Owner's Name: '-"E0 �� 1. _ce, Av ?.'s O r kb ° o • <br /> 11 //�� <br /> Property Owner's Mailing Address: 2.3c1. 2,_ �uv,NC�.�►ti. (0144...(act, Sj•n2../.. lA.N 1 94g?G-o <br /> ^� 1,. jv�-� City State Zip $ ' <br /> Property Site Address: 0't I v kC'►�^ I- C <br /> ) ( tom clr rS� p C I t �r) ' <br /> Contact's Telephone Number: 1 i S-2...9.2,- ,,(o`. / d21'Z-SZjt - Z` H o <br /> /(( o , <br /> Contact's Email: lc���04c,4--‘0 W.e.6_,1� V IScas .Cow... d <br /> J <br /> Legal Description of Property: L-c t' C. Sm Lte iC15 \I D CC f I 0 c •C <br /> N Section#: >S Town#: N Range#: I W Town of: h tit S 0 °o <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> d <br /> Tax ID#(1-5 digit number;found on tax statement): c.-;-.3 Na <br /> ?' ill a b �Q <br /> Proposed Use of Structure/Addition: pc...�-v` lkj CI. t)..L, ,. cA <br /> Anticipated Start Date:Dr r\.t ja..4. — ti t)t...) (Home/Cabin;Co mercial Business;Bedroom;De k;etc.) -�� F x <br /> Building Contractor: Sewer Installer: --7G,.yIc_e,s"' E XL . <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ti <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 11 <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to r <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z W <br /> home additions, and bunkhouses.** ;v (") <br /> p(.0 DweltA04 do euc o, becLeo✓hs f'e( 5/1(1/-d®�e�- all 5a04 <br /> Y! <br /> xx Fee Rec: ' <br /> / y Check#: i )t 3' <br /> Date of staff site visit: 6/8/?? Initials of site visi st ff: o * 193 tP 90 <br /> oz i 9 <br /> 10 rzi <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 6/O(?"a- �n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF r m 0 <br /> 7 <br /> m N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT I= N o <br /> Transcendent: - Page 1 of 4 °`` <br /> Y <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 g Iiil <br /> o `�' �: <br />