Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> Applicant Complete All Sections Below This Line o• cn CD w <br /> a <br /> Permit Types and Fees(Please,check appropriate boxes) t7 <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 <br /> O <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 1► 1 <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 U <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. A <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. CD p <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. =. <br /> z <br /> ,Property Owner's Name: .i�t(.._ CJ,olr.Nt... pQ <br /> 0 <br /> Property Owner's Mailing Address:{ e76C) 64-4'k_ i/ Y /41/. k. II 5l'-37 �. <br /> ity State Zip k <br /> Property Site Address: ,9,//lJ£ if, �a� ,(�51 Qr/eV✓ODG�r < <br /> ?? l - o C' <br /> Contact's Telephone Number: 3, _7 S G O..� ) L/ ° <br /> /J )) N C7 <br /> Contact's Email: ft vP /L sr154, ziG"°1 <br /> CD <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N -� <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and o °Q N <br /> @BurnettCountyWLgov / ti <br /> l �, �.�_/7/ 5. o <br /> �-C`- <br /> Legal Description of Property: f- C�jt<"j j iGt el <br /> � , <br /> Section#: ,�j Town#: 39 N Range#: /. /rG W Town of: t12,. J -. vi <br /> N*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* F <br /> W d <br /> Tax ID#(1-5 digit number;found on tax statement): C) <br /> Proposed Use of Structure/Addition: Aim E__. <br /> Anticipated Start Date: /- Z 4 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) (N <br /> Building Contractor: Sewer Installer: /} 'f l-vj 5/9-%` G/ ►v <br /> z <br /> ! -- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Dltl€&+ at Se,-I-bauhs �- <br /> D avalarl r -i-o -exLQ A Z bed%co v S per SPr -23-W-{ <br /> revp Shed onA Coxcio Cart-Eaai^tc -Eo be- remov-e-d of pe,,-m.►44td 104 4t112024 <br /> Fee Rec: X?C". <br /> P3 .eASo►\ poi-Gil -fp lot removed or (YL l4-4-e b b`{ q/11202.1-1 c t Check#: % <br /> ©A N planAVinl, 'i nc lc,i d.i ng Si yt,ks a'td wadcor s vi e -,-b be CcoYt nec e -ID-1-tLe <br /> S ari t-I-a n-( s's-ie.t'►'t 0. it-IAA) -a AAA_ of i n S-trut&4,'tyi Dr trt d ° ��J <br /> Date of staff site visit: ' l�Cj 1 ,4 3 Initial of site visit staff: x 0, <br /> n Q IMI <br /> APPROVED BY LAND SERVICES OFFICI DATE: 1( 2b2.3 rn co c c, 0 <br /> a () <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o 2 <br /> ram= N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT w <br /> IMI <br /> Page l of 5 rr <br /> rt <br /> Burnett County, WI Land Use Application—Rev 3/2023 LL JJ <br /> -3 <br /> a <br /> 3 <br /> -o <br />