|
LAND USE PERMIT ,tPPLICATION - Burnett Counts. WI 5-
<br /> - ti
<br /> N
<br /> _ Aippltcant i.'atripicte All 5.�;txatts B:IOW This Lint r.+
<br /> Permit Types and Fees:(Please,cheek appropriate boxes)
<br /> Dwelt ng,�'Prntipal structure $300 sed:-Tor/Atteratior to Dw,lling/Prircipal Structure $200 1 C�
<br /> .Commerciat/Industrial Structure S300 Addition/Alteration to Commercial/Industrial Structure $200 T-
<br /> Accessory Strvctu-e(Garage,Sheet,etc) . addition/Alteration to Accessory Structure $150 .�
<br /> Accessory Structure(Comrnerctal/industnal) Addition/Alteration to Bunkhouse $150 =
<br /> Decx/Stairs/Patio/Retaning Wali/Sidewalk Bunkhouse $255
<br /> Driveways/&Campground Structures S123 W State Statute 59.692(:v)Structures $350
<br /> Filling,/Grading SISC Boathouse $51) P ._
<br /> I Permit Extension(1 Year Extension-Allowed Once i S:00 - '1
<br /> NOTE:After the `act permit i,;permit aq:.ired ate eonstruction has begun may cost up to three times the normal fee. e
<br /> 'Communricat,bn Towers&Signs require a different aopkation form,see correspond;rq application,and lees. _ y _
<br /> 'Items not tested above will be treated as accessory structures, such as:pergoios, ioldscaping,etc ,
<br /> Property Owner's Name: °`-' #IA f'.4' ''1 l C' c( -- --)
<br /> r.
<br /> Properly Owner's Mailing Address. C- &' Titi.41 2,4/4 Or'-, tit et:E:?-�`�rriti, ft"i S-'/
<br /> t -'} city t 6014 zip -
<br /> Prop:n) Site Address ' ! t' f po r e a KTl4-'�J ,-.2,..,/2t„ S b _. •.,
<br /> Y
<br /> Contact's Telephone Number: (pc` +j ,---2....c b R
<br /> >:t
<br /> Conta 's Entail. -3 t AA Cddii E'CJ r4 GG (.15 fLi S C / le { V
<br /> Legal Description of Property t r" T._i -- &„J t &I u'
<br /> j s / ft
<br /> Section k;__.3 L_._.Town 14:..._. ? Range Pf- W I own of: S.-s, ivi40.4 Ft't-J f•1, ='
<br /> 'Atiai'h ihidittnrtuf pig,,el, rdeiliew tcng'Jn ckst rip:ion OR attach a c Deny of the deet OR analitIcaey start IPcre,n page •
<br /> Fax ID#)1-5 digit number: Lound on tax statement)-_._4 j 1> _
<br /> Proposed U;r of Sttucturr (
<br /> ,:�clitionf: ��'. ' / - e--'.e--'. f i , �i`�`_. �
<br /> Anticipated Start Date: [.i.t1't tP= et tr Cabin.C'utnrn.,-,ill/&:uorr+n, Sednx�en,DeoA chl `i`.,
<br /> Building Contractor: �.05euerinstaller: k.f4 fQcf)
<br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY
<br /> THIS PERMIT IS SUBJECT TC) ALL CONDITIONS LISTED BELOW:
<br /> **The aplrlicunt needs to contact their ID(Inverter to determine IJ a permit is needed from them prior to
<br /> ,,,----
<br /> .4N}'constrwctinn takirtig place for any dwellings,,dwelling additions.manufactured homes„manufactured
<br /> krrmr additions, and htrnknotows,** I
<br /> Nillef,-V-
<br /> A(� $e�4- I—.
<br /> h0. / �,�� .. J ee Ree. 4CI abp0
<br /> ! a' 5 Cheek z: 5.35 7�/
<br /> Date of staff site visit: { i 5/? ? Initials of :to nisi :1' , v f
<br /> tri
<br /> i J,
<br /> 1l'Pitnt'ED BY LAND SERVICES nFFTCIAl:: i.x1 t).t t l : ,J,t.
<br /> UPON APPROVAL: APPLICANT !UST POST COPY OF g T � '
<br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0.
<br /> fes =
<br /> Page I of 5 _ ,< NI '4,
<br /> Burnett County, WI Land Lse Application - Rev 12/2021 Y = t + ,;
<br />
|