Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI o- r <br /> . LA _ <br /> Applicant Complete All Sections Below This Line • <br /> c w <br /> Permit Types and Fees:(Please,check appropriate boxes) ° <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 r. <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 -J O <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 \ <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 <br /> 6 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. v . <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. C t <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. i '' <br /> z <br /> o <br /> Property Owner's Name: I,Ap►t„r 3 SA Tr3rJ o W <br /> Property Owner's Mailing Address: X 4,L LlQ,j;;Cte utx. J4i7. 7 n 01 <br /> �1- j City State Zip = 0 <br /> Property Site Address: ( /l)1 LI CtJ,Th;S Lc\ke. o y <br /> Cast j c <br /> Contact's Telephone Number: bJ i $qs.. .ri.2 9.1. a <br /> fi� ,Iu Q. `1 cl J o <br /> Contact's Email: rJ�1.� QN � � Gc:1++�' <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b 'o <br /> legible and your email provider will accept emails from the following addresses: @BumettCounty.org and °Q <br /> @BumettCountyWLgov ao <br /> tk <br /> Legal Description of Property: D•we,ti;N . C SW 4336-42,3 f.22.2 (l d 372z) Lot ( w <br /> 5. —. <br /> Section#: i$ Town#: albN Range#: I W Town of: iJ < (2 N tt <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* r\ NS <br /> W ,-3 '--3 <br /> Tax ID#(1-5 digit number;found on tax statement): 31-jz3 <br /> ho <br /> ot <br /> Proposed Use of Structure/Addition: ;�tQce.�t, S�t.a. (i .X.21) (_ S/ 4 . oot C31 <br /> Anticipated Start Date: I. 3 r 1, 3 (Home/Cabin;Commercial Business;Bedroom;De hnl <br /> Deck;etc.) -, n, <br /> d W <br /> Building Contractor: Sic Sewer Installer: iNkA re.cr oi'tea <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS OLY z <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> •(ULU.* CliJ Sk,-E-60,CiS <br /> * t` -l c hlmckn i+rk) INik <br /> Fee Rec: l 1(1" <br /> •Lock aud c u;l Cl taext On -j C `"A Yl l d S G/u_ Tt c Check#: 87O4 <br /> m <br /> z <br /> z <br /> v <br /> rt <br /> Date of staff site visit: 1 /2cn <br /> 5J23 Initials of site visit staf. J < ,— �--__ _—J <br /> F5 v <br /> APPROVED BY LAND SERVICES OFFICIAL DATE: --1 '2_4/&23 m a M <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o H H <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT , N Gm <br /> Pagelof5 < g w jU <br /> Burnett County, WI Land Use Application—Rev 3/2023 v �� JJ <br /> a <br /> 3 <br /> -o <br />