Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI c .0r Applicant Complete All Sections Below This Line 5 w <br /> Permit Types and Fees:(Please,check appropriate boxes) ca. <br /> e <br /> Dwelling/Principal Structure _$300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 •X O <br /> "(Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure 1 $150 <br /> .Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n (1 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° D ` (1 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 <br /> v) <br /> 113 <br /> Solar Panels(Stand alone or roof mounted) _$150 Permit Extension(1 Year Extension-Allowed Once) $100 h I —III <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. "\ ` `( <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 accessory structures,such as:pergolas,landscaping,etc. <br /> z <br /> 0 <br /> Property Owner's Name: het .., T NQ U)5.T •'(Pr_-11AAKq u i CT " <br /> v��b y a. <br /> Property Owner's Mailing Address: 2 " i g 9` E .-cC� C;�NI an'1 � Li/ Sy�3v E n <br /> City State Zip ° <br /> Property Site Address: NO fa,e # I c & Z.(OLcf be C. h6!L-v ki < y ,� <br /> Contact's Telephone Number: 9 5 2- 2 / 1 - 2 3 0 ( n. <br /> �t� o <br /> Contact's Email: •-i't'{ )t o b o(W l f a.-h o O .cow\ a. <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 0 "0 <br /> @BurnettCountyWl.gov ono <br /> 0/� <br /> Legal Description of Property: �'101/ ►JM OUT Le-/ .5. <br /> A-,,(, 5. <br /> Section#: /y Town#: 9e) N Range#: /5 W Town of: ei €J 7 r/ <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ` F <br /> ° 6 <br /> Tax ID#(1-5 digit number;found on tax statement): 5.'f <br /> Proposed Use of Structure/Addition: <br /> Anticipated Start Date: St S (Nome/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: ,_' f 5SCN S Sewer Installer: /1/4 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMITf IS SUBJECT-(, TO ALL CONDITIONS LISTED BELOW: <br /> 0 Meer �i 1 se-`�'.i cks , i <br /> 00 NoA. ' V h.4 4 h"'6,' -b v7 <br /> igAress ciz, be_ „II, 4.,, ps / 01 /12-3 <br /> ei ii Fee Rec: d 642 <br /> v Check#:! <br /> m <br /> z <br /> z <br /> � I a 2 K- <br /> <1 0. <br /> v <br /> jDate of staff site visit: 1 /) If 2-J Initial of site vi ' staff: <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: + (?;/,93 rr co <br /> in <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ''< <br /> 0 <br /> 'A Q Hi] <br /> u <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT v Q v' <br /> Page l of 5 Zr?..11< <br /> w viiii <br /> Burnett County, WI Land Use Application—Rev 3/2023 a , , <br /> a LL J <br /> i' <br />