Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI a 0 <br /> cn <br /> Applicant Complete All Sections Below This Line 0 w <br /> Permit Types and Fees(Please,check appropriate boxes) 41 n' �[ <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure Vi <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 r\ <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 N <br /> L7 <br /> eck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structuresi WI State Statute 59.692(1v)Structures $350 0 ^ <br /> Filling/Grading $150, Boathouse $500 <br /> cA <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. ' <br /> ro <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. g <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. E Gi <br /> i1 � o -'x. <br /> 2A'Property Owner's Name: Jp rGYQ \ H-(A Jt ', L�- �' ...._ 0‘14 t. % <br /> Property Owner's Mailing Address: 22-1 iL'. A A . L 1 r , ► ' ,i I 2 Al. - In ;4?•3- <br /> I ' ity State Zip ° L <br /> M p ,� <br /> Property Site Address: (�r4i � n���' ""► o E <br /> CD <br /> Contact's Telephone Number: a. <br /> Contact's Email:k',V P r0 rear,\n ava-)2023 @ m co,I • c. <br /> **If staff has a question Aout this application,you will bie contacted via email. Make sure your email address is N ro , <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and 0 °Q ^� <br /> @BurnettCountyWl.gov W <br /> • <br /> Legal Description of Property:W I ,1 Wr ( U 1 t P39 (*35 5/5 (NE NIA)) 5. - <br /> Section#: 19 <br /> Town#: 31 N Range#: ) f W Town of: k( T <br /> CID <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* f H <br /> Tax ID#(1-5 digit number;found on tax statement): 15756 ,1 0__ <br /> Proposed Use of Structure/Addition: <br /> N <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) W 7 . 0 <br /> Building Contractor: Sewer Installer: c'C1 <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Ogg_ . _, -.. . <br /> SF E 14-1740-1 eA - ,T ii/v4I4, et 4. ti. 4 F F--;:s-re ...4--ii,e <br /> hCAN �16t � S `� ( N (� L ( o i1� = Fee :q <br /> 73 <br /> 4 Check#:2 Y co <br /> 4 ) 1 i 4 laI(o 1,(Iveiv> o <br /> V h,4 Ott ao d z <br /> Date of staff site visit: jiz In + 1015 12Z Initials of site visit staff: rn <br /> < r APPROVED BY LAND SERVICES OFFICIA : ATE:6 D/(Q/2c523 C <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ' z <br /> fi <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT tr o= N <br /> Page 1 of 5 `.- fl <br /> Burnett County,WI Land Use Application-Rev 12/2022 v �` <br /> a <br />