Laserfiche WebLink
• LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line o c w <br /> Permit Types and Fees(Please,check appropriate boxes) C%.(*) <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 a <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p <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 /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Z. <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 t <br /> Filling/Grading $150 Boathouse $500 O <br /> c <br /> co <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. `5' tli- <br /> v � <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. § '! <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. S <br /> z <br /> iik <br /> Property Owner's Name: U �� � P(I�C al i " o <br /> o � <br /> '^ i /� o <br /> a. <br /> Property Owner's Mailing Address: (oI V)5 V• L 1C-e �d paw V IA WI �Sb w n <br /> �L Cit State Zip ° 3 r • <br /> Property Site Address:U/155 BASS �k� RA pAhbtAN 141 54 C1t)J0 4 <br /> Contact's Telephone Number: ,15- 33.e -9-843 a <br /> d <br /> Contact's Email: A!Me Cot I i ..33 e gnat 1 I• cow o <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ,-o <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and I oo °Q <br /> @BurnettCountyWI.gov - <br /> , o <br /> Legal Descriptionof Property:Lb{'9"CSM U2b { O 310�$�5)( � �01 3 C�Al VI P2 <br /> Section#: / Town#: �1 N Range#: /5 W Town of: S'/1/I ''7 (,O LOT L) <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> CI <br /> Tax ID#(1-5 digit number;found on tax statement): 914 11 -1' <br /> H <br /> (j(rIr <br /> Proposed Use of Structure/Addition: age � \ <br /> Anticipated Start Date: 10/17/2 3 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) I v ' im <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z 0--, <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: V\ <br /> 10/1)d- /0 ke- ose-a/ 4," AuvAcoA. Ace i/Xcol-fec,/t. , <br /> Fee Rec: / <br /> o• Check#: e Cal <br /> m <br /> z <br /> ' tA <br /> v <br /> rn <br /> Date of staff site visit: (0/,30/2 0 23 Initi is of site visit staff: y''i,Z < J <br /> ri <br /> �J f <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: /t/3//ZO a = <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF cr,OD <br /> -- inu <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o a <br /> fV <br /> Page1of5 < ,< w <br /> Burnett County, WI Land Use Application—Rev 3/2023 v 0 Ind <br /> -0 <br />