Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI <br /> Applicant Complete All Sections Below This Line ° c i <br /> Pp P CD , <br /> Permit Types and Fees:(Please,check appropriate boxes) C7a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ° 1 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 G O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ti CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 r N\ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° ` <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o N <br /> Filling/Grading $150 Boathouse $500 N <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. r <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. o <br /> Property Owner's Name: c'Al / )e_f//,-, a <br /> Property Owner's Mailing Address: g d o d J lV R,vfy) .v N )�G/ I`scc .f yf?G E. <br /> City State Zip c <br /> Property Site Address: 5/gniE . ° r <br /> Contact's Telephone Number: 7/5 (f"-c —3 757 d <br /> n) <br /> Contact's Email: bq r 13,v j Q y 5a€CvJ rn a 1 C', -- 8/'YIN <br /> 0 OQ <br /> 2. <br /> Legal Description of Property: �oq <br /> d <br /> Section#: (1 Town#: AID N Range#: 11 W Town of: V�L() a <br /> n <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> 14,rG v) <br /> �'i <br /> Tax ID#(1-5 digit number;found on tax statement): i-( - ,t 0 <br /> Proposed Use of Structure/Addition:LOOCd � �? C� <br /> Anticipated Start Date:Nit W C f (-1/� c—(Home/Cabin;Commercial Business;Bedroom;Deck;etc.) H + <br /> Building Contractor: Sewer Installer: <br /> ilt <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <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 <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured <br /> home additions, and bunkho es.** Si iiim ck <br /> )104) .--.1 <br /> CD Momr- co' Se.-bac(5 (/o,�. I'Y1e5 h°k � ® �'' c <br /> Nd-�- -6 b c / Fee Rec: ti`a <br /> y Check#: 1,,, 2 <br /> r o <br /> Date of staff site visit: 10/5` 2. Initials o site visit a : rn <br /> a <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 1 0/i 11 2a x _ �� <br /> Nil <br /> UPON APPROVAL: APPLICANT UST POST COPY OF E2 E. ,:_o <br /> ri CD co rrl <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT w <br /> CSC <br /> 511 <br /> -< 0o <br /> Page 1of5 rn El N Q <br /> Burnett County, WI Land Use Application—Rev 05/2022 < g <br /> m <br /> v • <br /> a .i <br /> 3 <br />