Laserfiche WebLink
. LAND USE PERMIT APPLICATION — Burnett County, WI cr `° <br /> Applicant Complete All Sections Below This Line 0 c tCD � <br /> Permit Types and Fees:(Please,check appropriate boxes) W <br /> v' Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 rp <br /> °' <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 o <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 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 n ? <br /> Filling/Grading $150 Boathouse $500 <br /> Permit Extension(1 Year Extension-Allowed Once) $100 E. <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. ,2 <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. i. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. T o <br /> Property Owner's Name: e M 1'i-v tf,,/,/E!A)CI Al 16 0 0 i� o <br /> a�00- 3 s�N S� 11/F i6 C ) 5 v 0. .-4---- <br /> Property <br /> Owner's Mailing Address: 4r'c IUJr ) E <br /> 7 ---�� City State Zip o y <br /> Property Site Address: 2 63/ c„�7 to I C ep <br /> 7�- <br /> Contact's Telephone Number:-i /5--7 g.) 9 4 �> K <br /> CD <br /> Contact's Email: C 1 Lek—!'^ a r to n CI y 4 I 117) I (1--h--, 0N <br /> 5CIO' <br /> Legal Description of Property: I d <br /> Section#: A C. Town#: 416 N Range#: / r W Town of: TQC. 00 g, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> in <br /> Tax ID#(1-5 digit number;found on tax statement): '�/ C/ S a <br /> o H <br /> Proposed Use of Structure/Addition: U p 1 G VL w i_ it 4a; ' r� <br /> Anticipated Start Date: c)C) + (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) V i <br /> Building Contractor:Ol/��'F, olah4 11C-hu,- R .L Sewer Installer: fT\ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY V <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: x <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 dwellingsifwelling additions,manufactured homec_manufacturedr <br /> ho additions,and bunkhouse ** _ <br /> pies cijI ,SG-b'- _ nq� <br /> DN/C ti dim- 4.r . ev..eecf a bejro s 9e( __54k �0� Fee Rec: ,K� <br /> J OT �e r� Wr Check#:L9 <br /> c � <br /> r 44,,54- be. ✓vw eJ 5 ev- pe b o <br /> Da a of staff site visit: 6/45/? Initials of site vii st: f: ,, z <br /> 110g4//' <br /> / / d <br /> APPROVED BY LAND SERVICES OFFICIAL: �i DATE: 6i 7/�ZIriiil <br /> UPON APPROVAL: APPLICAN UST POST COPY OF m 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT Q <br /> Page l of 5 NJ <br /> Nil <br /> Burnett County,WI Land Use Application—Rev 12/2021 < <br /> a <br />