Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI I <br /> • a. <br /> Applicant Complete All Sections Below This Line 0 c w <br /> pP P CD , <br /> Permit Types and Feeselease,check appropriate boxes) d S <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 v 44 <br /> i <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 Ns O <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C ' <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < ` <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 p `` E, p` <br /> V" <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 1 , <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. S <br /> z <br /> o <br /> Property Owner's Name: �/f I r of E S C * <br /> 0 <br /> 0 <br /> Property Owner's Mailing Address:/7 4/ Rl O D NL Y I/9/f L Ii7L7 o. 5 fop A/kW tV. 54 OJ 77. n <br /> City State Zip c <br /> Property Site Address: S i9/V C <br /> y O <br /> Contact's Telephone Number: 7/ 2 7"7 3 6 Y a 6 P. <br /> d <br /> Contact's Email: f)(6/V:- `% <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following addresses: @BumettCounty.org and °Q <br /> @BumettCountyWLgov t <br /> Legal Description of Property:PAL vi 62 Y 6-1- 3 S .t Q Wu, ' .,,,. <br /> 5. <br /> Section#: / 4, Town#: 1,0 N Range#: (4 W -"Town of: C / c„ <br /> T <br /> *Attach additional page if needed for lengthy description OR attach <br /> a copy of the deed OR attach tax system property page.* 7 <br /> Tax ID#(1-5 digit number;found on tax statement): / VC) /I ''"C <br /> 1� H <br /> Proposed Use of Structure/Addition: (O t 6 S/ 4,9 4,0A 2, 7 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) \ ! <br /> 0 • <br /> Building Contractor: Sewer Installer: <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJE T TO ALL CONDITIONS LISTED BELOW: ,...._ <br /> a(lee-4- 4 Ste- /,, <br /> IVA- ;=( litonet4 <br /> Rea( Dec it 7��A� �/`i°�S te I4ce /l v1 LY1 5e $;Z2 e� x Fee Rec:/ <br /> / <br /> P-0/8- ?oo;o needs c !hid vse petx,7 -cc/ s dec14 • m Check#: /L/13 <br /> c. <br /> Date of staff site visit: 1 3 I 1 �3 I 'tials of sit ' it staff: 1"1 < a <br /> APPROVED BY LAND SERVICES OFFICIAL: ' 4 &Ls DATE: 6fe*- y n <br /> 2 <br /> a 5'� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z co <br /> oo w Eitil <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT m Na <br /> . ,< w <br /> Page lof5 rn ' <br /> Burnett County, WI Land Use Application—Rev 3/2023 v �` 'j <br /> a <br /> i <br />