Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI z <br /> N IN) <br /> Applicant Complete All Sections Below This Line o CD I <br /> W <br /> Q. <br /> Permit Types and Fees:(P/ease,check appropriate boxes) � 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 kA O <br /> F <br /> Accessory Structure(Garage,Shed,etc.& •. $* Addition/Alteration to Accessory Structure $150 CD <br /> Accessory Structure(Commercial/Ind et \ ) Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/SideaV_ Bunkhouse $250 ° C> <br /> Driveways/&Campground Structures $ 5 WI State Statute 59.692(1v)Structures $350 W ‘ <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension Allowed Once) $100 ? ) <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. l/ <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 1. S <br /> Property Owner's Name:_ri i4n__D4 riot_ o <br /> o. <br /> Property Owner's Mailing Address: 41,4. )to.I o.r( 1,.(bk IW. IdeiSier fri. -S 1 G 3 <br /> N� � City State Zip � <br /> Property Site Address: /"\ <br /> o <br /> c <br /> CD <br /> Contact's Telephone Number: 7 L5- 8'6 6 - 3 Se 3 o. <br /> e <br /> a p CD <br /> Contact's Email: V (e✓111 c v r i c t+0 11)e-+L.D. g_. ►\ e� <br /> **If staff has a question about this application,you will be Contacted via email. Make sure your email address is -0 <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and E °Q <br /> 5' <br /> @BurnettCountyWl.gov ,�/ � De <br /> Legal Description of Property: 5W 'V Fes'Y _ F. <br /> Section#: 33 Town#: 40 N Range#: j.j W Town of: .u.. -►•rso,i v) <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* y.. b, <br /> o '-3 <br /> Tax ID#(1-5 digit number; found on tax statement): cci <br /> H <br /> Proposed Use of Structur4ddition: S f ro•!�P_ i. .SJ <br /> Anticipated Start Date: O1 - (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) re, �� <br /> 0 <br /> Building Contractor: Sewer Installer: II <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO .ALL CONDITIONS LISTED BELOW: <br /> l-ce4- All 544cL5 01 <br /> vot-Ci 1,44,4ta4 A 6-J-h'o <br /> Fee Rec:$t,6 CO <br /> o▪ Check#: B(7 R 5 <br /> m <br /> R <br /> z <br /> o <br /> Date of staff site visit: 3/ 7` Initia of site v' it staff: 1-11 < c <br /> ii n <br /> APPROVED BY LAND SERVICES OFFICIAL: ( t DATE: 3/13i? 3 a 0 co <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z -. �_ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0. w Q <br /> Pagelof5 < co 11111 <br /> Burnett County,WI Land Use Application-Rev 12/2022 `13v �L JJ <br /> a <br /> K <br />