Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a r <br /> N <br /> ' Applicant Complete All Sections Below This Line 0N <br /> Permit Types and Fees:(Please,check appropriate boxes) a S. <br /> d <br /> Nie Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ..0, <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150CV <br /> -, <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150n, <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 N v <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension Allowed Once) $100 ?. <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. g <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> ..........• <br /> ..., ^il tg. e---\ <br /> ,IL' <br /> Property Owner's Name: / O f(K /G 6 a Ts <br /> 5 . <br /> �- <br /> IW t <br /> Property Owner's Mailing Address: / ,3•Q'e c1 2t fh /CD <br /> City l State Zip c <br /> Property Site Address: '2 9 0/ co c//)--/), oen a C1 N '10o-A&-tiF tivi .0-1590 <br /> a. <br /> Contact's Telephone Number: 657- v <br /> o <br /> Contact's Email: 71-6 c/ri�e)40 10 € 3/h d I/• CO �'' <br /> 0 aro <br /> Legal Description of Property: 4.6/ CSjM( , v6IlL¶ P729 COV / O-4 I o <br /> d <br /> Section#: 9 Town#: 10 N Range#: /4 W Town of: Sc 0 <br /> a. <br /> e) <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): 3s-171 F a <br /> Proposed Use of itiop:Structure/Ad <br /> +� Ref ui,e <br /> Anticipated Start Date: / 1/2 J 9 (Home/Cabin;Commercial Business;Bedroom;jDeck;etc.) c '1 <br /> Building Contractor: iCrIv ✓% /r 0 nt 6/5- Sewer Installer: fi-Op r v` <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 7:) <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> ho,,a additions,and bunkhouses. * <br /> k Q(( s <br /> 00 <br /> tD�►eIt sok ereeeS 3bfr.( ��, 117 SN• Fee Rec: 0300 <br /> 0 )<* c4b+en 4 /ha; ►tc.vtre . .cnisi volt , is re n.04 nr, <br /> e- o c`:,) Check#: te$32 <br /> da he bK.14- � �-�s o <br /> Da e of staff site visit: 61?3/2.2- Initials of site visit to :, L r <br /> j / / d <br /> APPROVED BY LAND SERVICES OFFICIAL: , p DATE:6!p 8 ` 2"? , <br /> UPON APPROVAL: APPLICAN / UST POST COPY OF X �` <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT `...' <br /> CD C <br /> NI <br /> Page 1 of 5 5 <br /> Burnett County, WI Land Use Application-Rev 05/2022 <br /> - <br /> 3 <br /> -o <br />