Laserfiche WebLink
' LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> 1 b <br /> Applicant Complete All Sections Below This Line 0 w <br /> a. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 P. OQ <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ..L3- O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 co <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse <br /> .SCV`141 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o w g <br /> Filling/Grading $150 Boathouse $500 lJ <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. ro <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. h <br /> • a <br /> Property Owner's Name: jek_+.p4 l{Zid 'vVh Q9 o <br /> Property Owner's Mailing Address: (455 jt/ C i2t lrc e TR( )Q.rri 5 MA/ 55DJL 1 n Pi <br /> City State Zip <br /> Property Site Address: I Z t' S r7 GQLA- RP 7,-- Grefr vim'( j o N <br /> CD <br /> Contact's Telephone Number: 65/ - ({e!7 ` /QQri J a. <br /> ��!! <br /> Contact's Email: ict t_ M-P tSe col. .cp � ,Ti-,, <br /> staff has a question about this application,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and °O <br /> @BumettCountyWI.gov Lo ; (5m ,f'33 1? V i L Pavo 41 31`'6.9s w <br /> P. <br /> Legal Descri tion of Property: 0 7- Q 3 y - Z " 37 - /Cr_ Z. - - 'b 05-Oo I-0/'/n Q' :. <br /> Section#: Q 1 Town#: 3 7 N Range#: � g W Town of: Iv'A La(�._- J I� <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 7 ,) F 5 <br /> Tax ID#(1-5 digit number; found on tax statement): c)9 I 'S \ <br /> Proposed Use of Structure/Addition: (3 Li,3�,Lk,,A,,_,.... --� <br /> Anticipated Start Date: 3-Si- L 3 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Q) <br /> C) <br /> Building Contractor: ,}?,..p. Sewer Installer: '(t <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/Co DITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1 Wheel- all Ski 140 <br /> • ?wn k{ta.-se_ cct,i he-)- 14 In2 Ctly i✓lcic P1(414b1. <br /> 1.011OtAi ct,u &I I(h ,5-e- Ciq,e. 1C(7L' � �Y11 1 Fee Rec:5? <br /> 0CRN�lPP.r Ca/7 Kdd- v rti J�^ 3 -Wit( �f�5 ./1 G �L o Check#:36o <br /> U m <br /> ear u <br /> rn Date of staff site visit: q /''/?" Initials,of site visit staff:1-1 x r I�l)i <br /> APPROVED BY LAND SERVICES OFFICIAL? DATE:F1,31a 3 , trit <br /> , 3„.. <br /> al —0 a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o CD 3 X•r 0 + oilSIGNED PERMIT APPLICATION IN PLAIN SIGHT . C C o <br /> R Bs' .‹ N v <br /> Page l of 5 < -' <br /> Burnett County,WI Land Use Application-Rev 12/2022 o w <br />