Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> . s b <br /> Applicant Complete All Sections Below This Line 0 c w <br /> Permit Types and Fees(Please,check appropriate boxes) ii a. <br /> Dwelling/Principal Structure $300 )( Addition/Alteration to Dwelling/Principal Structure uurD <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ' ,-kk.O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ��\ i <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150j <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 W <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 S' <br /> Filling/Grading $150 Boathouse $500 VD <br /> IlD <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E. f. <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. g• <br /> r <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> z <br /> Property Owner's Name: . 'f.F.F E Iv; S' V'i�6%'J i1 v <br /> ' ,,i SE.;L`.tC{t __..-1__..-1 =' 9 <br /> ) <br /> Property Owner's Mailing Address: t")?.)�i c'11 PI ice-\fA. �1 1)�h'gae2: W,, 1 �'I 715o' n <br /> C <br /> 3f' <br /> City State Zip ° E <br /> Property Site Address: yP`tiYl(~. <br /> a N <br /> • G <br /> Contact's Telephone Number: 1 (S' '3-It- O(-}b "' <br /> d <br /> Contact's Email: N A <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ro •000 <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and °Q N <br /> @BurnettCountyWI.gov cm ---___ <br /> d <br /> Legal Description of Property: �r� 3. <br /> Section#: •?,, Town#: ) N Range#: I(c W Town of: ., t:,,:i., j <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* E <br /> a 5 <br /> Tax ID#(1-5 digit number; found on tax statement): <3 ; 7% CA <br /> H <br /> Proposed Use of Structure/Addition: r_c.i i-c. C. �K i VI-1 ;Pk- -0tC.k • N <br /> Anticipated Start Date: 03n\i (1-4e l (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) .-t N <br /> Building Contractor: Sl (= Sewer Installer: <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: _ <br /> - + ate 5A:HOa -S s <br /> - S (- sy9eAm A-� \OR- SerV CkA b"-{ $ 11 I -3 <br /> Fee Rec: Q1] <br /> o Check#: 445� <br /> m <br /> z J ' <br /> a �__��J <br /> Date of staff site visit: 3/2 Oo2.3 Initials of site v' staff: < <br /> U <br /> � t /Jm <br /> S <br /> APPROVED BY LAND SERVICES OFFICI / 4 : L1 /s/2()z_-' ) D 0 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o N Iwo <br /> z <br /> 0 v <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT j I <br /> w 2 <br /> Page l of . MI <br /> Burnett County,WI Land Use Application-Rev 12/2022 0 - �` JJ <br /> a <br /> x <br /> o <br />