Laserfiche WebLink
W LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 0t <br /> CD 1 <br /> Permit Types and Fees:(Please,check appropriate boxes) b c" (� <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 P; .. <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 6— O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 at <br /> at <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 � <br /> (1—\ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 —t- <br /> Filling/Grading <br /> l � <br /> Filling/Grading $150 Boathouse $500 X� `' <br /> Solar Panels (Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 _ <br /> i <br /> N <br /> *NOTE:After-the-fact permits(permit aqui red 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. 0 <br /> *Items not listed above will be treated as accessory°structures,such as:pergolas,landscaping,etc. o <br /> Property Owner's NameA3.=4 r,—, IF‘t ^. °. ' " <br /> Property Owner's Mailing Address:vZ ?/S CGN CS B''C y iPel i-3dh`C.r 1"-)X „<t/W `3 n <br /> City State Zip <br /> Property Site Address:,2-))8 CoN V C QCT d p 62,a, ° <br /> 0. <br /> Contact's Telephone Numbei(76) / I o —S-901 d <br /> CD <br /> Contact's Email: k,'%4&J3 /L dLe•. a 6_,,,,;1 •COIN- <br /> / o <br /> o a <br /> a <br /> Legal Description of Property: % 2... C'7/V^ L. /e? P9,, 2.-V . <br /> t N <br /> Section#: Town#: 39 N Range#: /U' W Town of: R.-e lN01,..t N <br /> a. <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): I 16 gl-f v)A c <br /> Proposed Use of Structure/Addition:(s--v 7 d <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) \ ^3 !yl <br /> Building Contractor: Sewer Installer: <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 Po <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes, manufactured L.....,\„.. <br /> home additions,dion� and bunkhouse .** / / <br /> k/('O/ 7� ke- ll�G�'�Y bt/.�/►4v1 !x!4!0/ �ml�,/1/GS./DG/C— te_ 4N/H/1Qls c7 JA A07 cYPol.JC�G 44 /He- �/e",3 _i Fee Rec: -LXX <br /> / to ' e, Check#: �'ra& <br /> cx1 7�1'1 c� of' q c.dti�,jryovr 4 � t,�Se- <br /> n2.��u�'tt4171-4, o <br /> Date of staff site visit: �p �i/C.�Z7i- Initials of site visit staff:_ Y//' <br /> r a ' <br /> APPROVED BY LAND SERVICES OFFICIAL: ATE: ‘7-3/�Z Z <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF m m0 E/99 co <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z o Niji <br /> Co7 CO c IV <br /> , N <br /> Page l of 5 ^' <br /> Ell <br /> Burnett County, WI Land Use Application—Rev 05/2022 <br /> v, 1 r---�--� <br /> v C�_�J�J <br /> a <br /> 3 <br /> -o <br />