Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> Applicant Complete All Sections Below This Line 0 � w <br /> Permit Types and Fees:(Please,check appropriate boxes) n' r <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 co <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 i <br /> F4Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150G) �/Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< ,\�v(Driveways/&Campground Structures $125 ,WI State Statute 59.692(1v)Structures ,$350 r > <br /> o <br /> Filling/Grading '$150 Boathouse $500 b <br /> cA <br /> co <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 o. <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. @ <br /> *Items not listed above will be treated as accessoryn structures,such as:pergolas,landscaping,etc. l g z <br /> Property Owner's Name: ()/"/,{U�- I\()/i) , I--1/.iJJ f'l C K c" !v o • <br /> o i <br /> 0 <br /> Property Owner's Mailing Address: '7 G 2'1 S,-Ali , R j vtv Ski) r4UD0A7 W1 I n a. ' <br /> City State Ziphli <br /> Property Site Address: 76,2 7 SCVf� �,,i.. R� n ��C. �c , v 2 ° C N \ <br /> Contact's Telephone Number: L/2 — i.50 —.C.2.5 7 a <br /> Contact's Email: D{} E,({0 KrC SG ,V 6 ( t G /}l GZ; 1. . (o M `= o <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 a °0 <br /> @BurnettCountyWl.gov 1 <br /> C. <br /> Legal Description of Property: it/ '/2 S l 3 E 5tv i7 <br /> 5. ID <br /> Section#: ( Town#: Ya N Range#: 19 W Town of: U/!i`O A_ <br /> v, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* F <br /> Tax ID#(1-5 digit number; found on tax statement): <br /> )..57 6ei <br /> !., 9 ....: <br /> Proposed Use of Structure/Addition: V'n S .'V� 2 <br /> Anticipated Start Date: 9 — /5 (Home/Cabin;CoOtinercial Business;Bedroom;Deck;etc.) <br /> Building Contractor:Ney 1.—a,4( 13Vi/d -S Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> CD r e..' 4,L\ 54 <br /> g <br /> Nal— hK4.4m {��. ;1 'o4 / J- 4 btj /,e <br /> CAr �/f7�t E' I ,...„,„.., <br /> x Fee Rec#4)I/ <br /> _9 �!>4 / 1 Ie ' Check#: 1�S <br /> ��tX �}vra�C' SGec� Co/lSri -+t 5 Co o (�h <br /> m <br /> z <br /> / I / i __,,___JJ <br /> Date of staff site visit: X l yJ it' is f site visi staff: WE v <br /> r- <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: -3/a 3 <br /> CD tW C 0 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF CD C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ' cc <br /> V= N <br /> Page l of • K w <br /> Burnett County, WI Land Use Application—Rev 3/2023 <br />