Laserfiche WebLink
/ • LAND USE PERMIT APPLICATION - Burnett County, WI g <br /> Applicant Complete All Sections Below This Line stv <br /> tit, <br /> PP mP o n `I W <br /> Permit Types and Fees:(Please,check appropriate boxes) 5, ti <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 P; <br /> NO <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 C>[ <br /> Accessory Structure Garage, .hed,etc.) $150 Addition/Alteration to Accessory Structure $150 p <br /> /- 1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 C: <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250• o e <br /> ...... <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 orb <br /> Filling/Grading $150 Boathouse $500 ,t <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E. r— <br /> ,2°' s <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. g' <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o Z <br /> Property Owner's Name: /4 ark <br /> 1 I-0 N 4/1 e1 L,r sthr e.i OD C $, N Z <br /> Property Owner's Mailing Address: 2 34 414 e Ise r.e Road lode 6SIu uv t- ° . <br /> Property Site Address: e 37 L e I SC AC. Rol• �/`r e'�sp- w y•te Zip o <br /> I et„ <br /> Contact's Telephone Number: 7 ( s^' -733 ' 0/ yy N d <br /> Contact's Email: yhark I iiv►sc k e; d oi. hof,AQ/i• corri N C3 <br /> 1 <br /> 0 <br /> a <br /> Legal Description of Property: 0 / - 01 (1 'A '3 9 -17- 12 - I O y -0 0 O. 0 t 2. 1 DO CIQ <br /> ' <br /> G <br /> Section#: '2. Town#:-31 N Range#: 1 7 W Town of: L in c 0 I ri r <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a`copy of the deed OR attach tax system property page.* ' <br /> ii <br /> tA <br /> Tax ID#(1-5 digit number;found on tax statement): / / '7 7O J X <br /> Proposed Use of Structure/Addition: W N d <br /> Anticipated Start Date: rn ay .2 t>23 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) a ^, <br /> ✓ (Ai <br /> Q Q /� / a <br /> Building Contractor:Al Art L-i A S G-h,t j d Sewer Installer: (A 4d e I`t1 (5'#4 O f/Ai al <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <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 70 <br /> ANY construction taking place for ant'dwellings,dwelling additions,manufactured homes,manufactured -- <br /> home additions,and bunkhouses.** •� <br /> - Ntee-k- WI se,-Noac.�c S <br /> -�-i r,(\ a Fee Rec: 15bUD <br /> -Nt+ -C-Or .nn u n 1n�1ot-l-�- 1 rJ <br /> y Check#: 6156 <br /> q a <br /> Date of staff site visit: 5l l /2ol3 Initials of site visit staff: <br /> o <br /> rn <br /> —Jl J <br /> APPROVED BY LAND SERVICES OFFICIAL: DATES/K /2o2 I�-,�.,� <br /> < n UULI <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF N T W n <br /> a .3 --C <br /> CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z 2 ifyll <br /> c cp <br /> c �z N V <br /> Page l of 5 A 2 w <br /> Nil <br /> Burnett County,WI Land Use Application-Rev 05/2022 < ' LC�J <br /> m <br /> O <br /> H <br /> -.3 <br /> II <br />