Laserfiche WebLink
co -cl <br /> LAND USE PERMIT APPLICATION—Burnett County, WIcr <br /> Applicant Complete All Sections Below This Line z c , <br /> Permit Types and Fees:(Please,check appropriate boxes) f <br /> o Q5J <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 S, <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 $150 P, <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 c, N <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 1 2— <br /> Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. n <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. a I <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> Property Owner's Name: M i(l1 Mil t k d ( NIr.,i+tb(Yi.- ° <br /> Property Owner's Mailing Address: I �1 Ol4S V%1 W1 t- to 1 er 144 v'(I�C MO 5)0 <br /> Cit State Zip 1 C <br /> L i � ���® 0 <br /> Property Site Address: 3( 4 S r4 1'Q', 1�""` a T-144/At <br /> (il4/A w i `j+- q10 n <br /> Contact's Telephone Number: 1,/I 2.- 3R —um) d <br /> L2. <br /> Contact's Email: 41}����}�4/1�7 6, G•r I-l", 6.,---5 -Ca 3s*fiCG) o ao <br /> Legal Description of Property: .JAL Or i!b, /c Lad-i at,iitIL V7' L (t �` <br /> � � d <br /> Section#: 0 Town#: qt N Range#: I i/ W Town of: '7$ . <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): C 1 zJ <br /> + ____llll���, <br /> Proposed Use of Structure/Addition: c Gl r� hr-, 1 c . '1... a El- <br /> Anticipated <br /> Anticipated Start Date: '"54,,,,,, c L2, (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ' ( i <br /> Building Contractor: — Sewer Installer: UN <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY CJS CZ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z Ul <br /> **The applicant needs to contact their CDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkhouses.** <br /> ( 01‘45-f- Mee—i— 411 Sedgy- . , <br /> t' L � <br /> Fee Rec:J 5S !/tf- iS O/1 O. P(O1 - "Q 5lgfleU -)-6_ N Check 3I-6/ <br /> orok,/q/ � ' W0.4& //1t, - /40' 1 "4 /5 IJe/ /• <br /> o <br /> Date of staff siteVisit: ,j /5/7- -- Initials of ite visiti/a'•, <br /> / z <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: b 000-9_ <br /> UPON APPROVAL: APPLICA ► ST POST COPY OF <br /> 'y-i <br /> 7 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o J <br /> Pagelof5 EuU <br /> Burnett County,WI Land Use Application—Rev 12/2021 < to co C <br /> ,› N .... C YuY <br /> .0 w <br /> is o c <br /> i <br /> LTJ <br />