Laserfiche WebLink
K LAND USE PERMIT APPLICATION —Burnett County, WI a <br /> Applicant Complete All Sections Below This Line ° i <br /> Permit Types and Fees:(Please,check appropriate boxes) n <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 CoQ 0 <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ^� TDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °e <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 <br /> r <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. o <br /> i= a T Mt7a6 Rtv -re u S l <br /> Property Owner's Name: .._ 1 Z ��� t� i�' W ► a. i <br /> �^ w, n <br /> Property Owner's Mailing Address:3 lEi2f'CI1'NHAvevV'Te._L L,Il ICrO4. co 'o1Z3 ' <br /> City, State Zip �a <br /> Property Site Address: `2. S f)1 5 'B..,))._(.14. .si istA.fl i--AC 1"12-. bA-wb.pz:y 9j t7... . ° c <br /> a. <br /> �` <br /> Contact's Telephone Number: 13 D '7 1--. S lob-2' v 9 y d r <br /> --i <br /> ' <br /> Contact's Email: -biy • t`_ o m <br /> `Ch a• P'e. e i S©rL' 1.0 te rn o � <br /> Legal Description of Property: LOT I L.SMtt -407 Z L Z 7 P1 S'S 4 ..7 *456 3 ' v <br /> I\ <br /> g <br /> Section#: 16 Town#: 4 0 N Range#: I ! W Town of: S COT ' 7 W <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Lv) <br /> Tax ID#(1-5 digit number; found on tax statement): 35 2 [`,v .� F <br /> P D �JC�- D oe <br /> Proposed Use of Structure/Addition: w� S L ���S C 5 <br /> Anticipated Start Date: 5 'L 7 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) N - <br /> Building Contractor: ckl°vetsd C(9Ut ST Sewer Installer: jOiLt `\A <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY r► <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 z 4 <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured <br /> Thome additions, and bunkhouses.**r J <br /> &/Vo� 7 ' k usei -Go A//mat� Lta t/IiVemT1oli1 , <br /> - Fee Rec: I5-611) <br /> Check#: J p/,/Lt <br /> o <br /> Date of staff site visit: O/Z3/Z40Z'T' Initials of site visit staff: 117- <br /> r <br /> z <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: �Z04Z z' mp <br /> ri IM <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ? <br /> .� <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <br /> z <br /> Pagelof5 7Burnett County, WI Land Use Application—Rev 05/2022 <m <br /> v <br /> a <br /> i <br />