Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5 N <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) � C Li <br /> \' Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 f.1 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 -, <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 R <br /> 0 N C. <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 t <br /> cn <br /> Solar Panels (Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 �_ <br /> r <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. or 2 �, <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. D <br /> Property Owner's Name: '` /— j a o <br /> P Y �' At FS' 1�c`d S N <br /> Property Owner's Mailing Address: i,( j 3 / ,,{, RI <br /> 1'fik� ° 4.0 <br /> _ City State Zip <br /> Property Site Address: / t,-"cw' c'1 ° N <br /> Contact's Telephone Number: I �Q d <br /> p 7r5 — �' —1r7 � <br /> ,,CD <br /> Contact's Email: N ,,, <br /> 7 UQ <br /> Legal Description of Property: C b 3 '7Jt) VO 'PI /2 /v 0. S C <br /> d <br /> Section#: '3 Town#: ,'.f 0 N Range#: ; ' W Town of: c-' • <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copyco of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement): 3 (c' 2 Q , C <br /> Proposed Use of Structure/Addition: f p r..' ° <br /> Anticipated Start Date: . a-? (Home/Cabin;Commercial Business;Bedroom;;Deck;ec etc.) .-3 t."\, <br /> Building Contractor: 7-t,,.., 'je,- Sewer Installer: ® .s Jo L/.—L._ <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ' 1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to pJ <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured <br /> 01 <br /> home additions, and qunkhouse .** <br /> (r1 e -k- of I l Se-k c S �¢�j <br /> 0 l�(Ll. ` G'e 3 cen$ �JQ.1�-2.a'/ Fee Rec:2 <br /> (�C� 'j : Check#: 1 35) <br /> / 13 <br /> l 1 r <br /> Date of staff site visit: 1 t 1 1 ! 9-01 Initials of ite visit st f r <br /> vc, <br /> a <br /> (kt . - <br /> I /3/?-z <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: A <br /> r <br /> UPON APPROVAL: APPLICANT UST POST COPY OF W <br /> cn <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z N a � <br /> CI <br /> (a Q <br /> Page 1of5 pi4k <br /> Burnett County, WI Land Use Application—Rev 05/2022 < 2 lfl <br /> m <br /> ° �L JJ <br /> a <br /> 3 <br />