Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI <br /> Applicant Complete All Sections Below This Line g <br /> Perm Types and Fees:(Please,check appropriate boxes) L1 (i, <br /> /Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 n <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> ID <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 Ni ., <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 O <br /> Filing/Gradirg $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> A <br /> •NOTE:After-the fact permits(permit squired after construction has begun)may cost up to three times the normal fee. <br /> L.I. V0 <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. , <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ;? <br /> Property Owner's Name: i .e. iA-C1Y, 9. Z <br /> uNop <br /> Property Owner's Mailing Address: 1 ,©, && I V LI c .Gotx `cJ I5. Liz S'1 0,1°o <br /> /tryt. City State Zip -tProperty Site Address: Z-(o 3 Pcje r J`Pt, S p 1r p' <br /> Contact's Telephone Number: 6(Z.- S7 S"-- ?"6760 ' o " <br /> ii <br /> Contact's Email: (<42 14 @ �yz$ -5-e,r V, C6-1-1'1 o <br /> Legal Description of Property: tiffs ( f PktS SA O2r az <br /> � <br /> _ N <br /> Section#: 1Z- Town#: 39 N Range#: /4 W Town of: R..tf rC.. 'o ti tl° 0..) <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system,propfr•tyipye.* b <br /> chitS4 W <br /> Tax ID#(1-5 digit number; found on tax statement): /(9 14 ZJ 5. <br /> Proposed Use of Structure/Addition: Cf-4 10M cn <br /> Anticipated Start Date: 1 , '- <br /> Zdz (Home/Cahin;Commercial Busines/s;�Bedroom;Deck;etc.)j0 k <br /> Building Contractor: P�.- S Sewer Installer: (v2 (di.A1 r'1j �" <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY -� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: j _ <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 dwellings, dwelling additions,manufactured homes,manufactured Z <br /> home additions,and bunkhouses"** P <br /> Me6 all -eA-bel, 1 <br /> Neild ,110- {a ex a bedrceins pec5 ? ?3d <br /> z Fee Rec:3jj <br /> Check#:10h( <br /> R/6i�aZ <br /> tr <br /> Date of staff site visit: Initials of site visit t. i' <br /> 171/27 <br /> APPROVED BY LAND SERVICES OFFICIAL:li- ',.aCti �� DATE: / I-3 Cji <br /> ^ <br /> r- , Uuu <br /> UPON APPROVAL: APPLICAN " UST POST COPY OF � a to E 0 <br /> -.m <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0, g __- <br /> Gil <br /> Transcendent: - Page 1 of 4 a c4 <br /> R 2,e <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 12/2020 5 74 iv <br /> I' <br /> v It <br /> 4 <br />