Laserfiche WebLink
• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 0' cw <br /> O. <br /> Permit Types and Fees:(Please,check appropriate boxes) q <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 © <br /> 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 /> INI <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> riveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 S <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 W <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. i <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. P , <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g' <br /> ((�� z <br /> Property Owner's Name: �K� Q IA?5 GL.) o I <br /> o <br /> Property Owner's Mailing Address: 17 q I Rcve LA h.c Y' �g J w n <br /> s/�c�rLZl W�- s O <br /> Cit)1 State Zip E <br /> Property Site Address: //)1'e <br /> o <br /> h F,Contact's Telephone Number: 7 5 - 7�3 3 OS 017 ° <br /> d <br /> Contact's Email: ni(,'n <br /> **If 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 tl0 <br /> @BumettCountyWl.gov I <br /> J /� I (� 5. <br /> Legal Descript' n of Property: ` I in ✓Oli 101'3 ` �i 5 p7Y R004t q <br /> Section#: Town#: LI 0 N Range#: 1 Town of: p <br /> 14 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ,` <br /> Tax ID#(1-5 digit number; found on tax statement): 1 0/ qH - <br /> Proposed Use of Structure/Addition: G <br /> tA <br /> Anticipated Start Date: Qv✓J.e— (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) c , <br /> Building Contractor: Sewer Installer: <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 7yfle - c 1( 54 , 5 <br /> x Fee Re <br /> o Check#: 17 <br /> m <br /> z <br /> v <br /> U <br /> Date of staff site visit:.//C/3b3 Ini is of sit visit staff: I I < <br /> APPROVED BY LAND SERVICES OFFICIAL: t/: DATE: !O[0! �3 y n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF I�nl <br /> 2 CD N (lull <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT . CD <br /> R w`< N <br /> Page l of 5 <Z. g `A' <br /> Nil <br /> Burnett County, WI Land Use Application—Rev 3/2023 v I ' <br /> JJ <br /> 3 <br /> to <br />