Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI to <br /> Applicant Complete All Sections Below This Line a w <br /> Permit Types and Fees Please check ap <br /> propriate pproprlate boxes) <br /> C Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 U3 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> k, Accessory Structure(Garage,Shed,etc.) $150 ,Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wail/Sidewalk Bunkhouse $250 < :---\ <br /> XDriveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 s' <br /> Filling/Grading $150 Boathouse $500 .. N <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 (' <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g" ' <br /> o 1 <br /> Property Owner's Name: —Thomas Tina- SG12Lu/ (77na. M ShMQ-r 7 - 4—) c <br /> .r 0 <br /> Property Owner's Mailing Address: gall WLSf- &Q (1iur-t-- hA gf,A� iuAi. s 3I j a n V <br /> Property Site Address: 30!5( I4 V'Z.-s L)� / City State Zip < �` <br /> Contact's Telephone Number: "I GJ 2—2 l b--Too I a <br /> j o <br /> Contact's Email: '"S`'12 A 1'1- �d Y l to 1CC I I. corn :: <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is ,0 <br /> legible and your email provider will accept emails from the following addresses:@BumettCounty.org and a <br /> @BumettCountyWl.gov o <br /> A� <br /> Legal Description of Property: M i nntwiut kjn Park.Asseoor$ PI ,4-14 10 q tad-it 1 I <br /> S N7-i n a o� 1p 3. <br /> ,3 <br /> Section#: 0t7 Town#: -/1 N Range#: /5 W Town of: Swiss y <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* f� i E <br /> Tax ID#(1-5 digit number;found on tax statement): c 2753 ,dri vuoal W �1 t7 <br /> CP <br /> Proposed Use of Structure/Addition: t Starve- (60�( q0 J')` 'dy)30 y EAnticipated Start Date: �/ Home/Cabt►t,•Commeal Business;Bedroom;Deck;etc.) Y c—r <br /> (u)s C } Plt�rnbi .1 r ` ' <br /> BuildingContractor: r <br /> �h2.t'1 Y1LLt7I� /�[;t(/ i /t ewer Installer: ]a Gay�r �wLA) <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENT /C NDITI NS ONL Pi <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> i y2?ee-4- a a Se 1S - I <br /> Olk tuAmakt 1/4191 fi b <br /> g Fee Rec: 156e <br /> 8 Check#: I L‘e75 <br /> iTI <br /> Date of staff site visit: LI r 2"S/ 3 I itial of?site isit staff: I'I < <br /> APPROVED BY LAND SERVICES OFFICIAL` i DATE: Ala 61a 3 `_, JJ <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 0 a W x <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT fk a r <br /> Pagelof5 V1 �_ ry <br /> CM <br /> Burnett County,WI Land Use Application—Rev 12/2022 0 ,< N <br /> U <br /> J <br />