Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI a @ b <br /> Applicant Complete All Sections Below This Line 0. CD w <br /> Permit Types and Fees(Please,check appropriate boxes) a <br /> C 7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 .1 <br /> x . <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> i <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 .- <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °f Fl <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 IT w <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> -o <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. `D <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ' <br /> z <br /> 0 <br /> Property Owner's Name: 14_41(i C IL J- LJ Q,is k =' (il , <br /> � V °o0. tV <br /> Property Owner's Mailing Address: 513(/ ON Ve( Ave-S. M P h. S5411 n w \ <br /> City State Zip 4 <br /> Property Site Address:58 7 K/,S-kk f11 -y a <br /> Contact's Telephone Number: 1 —83 /g'�d d'II <br /> Contact's Email: r &-f'ICAC.I,oa,(S�I 110Vl1 e J vvvl I. 0 ol.'vk <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b ,� <br /> legible and your email provider will accept emails from the following addresses:@BumettCounty.org and 00 <br /> @BurnettCountyWl.gov so <br /> Legal Description of Property: 1,01' 5 CS NI#t-15 v Sr p I (P%N GDU Di q 4' giG PIeT <br /> Section#: 'I Town#: L+I N Range#: 15 W Town of: 5 w T,S.S f a Stt`9t vcn <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.*) , E n <br /> Tax ID#(1-5 digit number;found on tax statement): ,I L'� O N <br /> H <br /> Proposed Use of Structure/Addition: S f,a <br /> Anticipated Start Date: 1$. I�'�I 23 (Home/Cabin;Commercial Business;Bedroom:Deck;etc.) ...C....C. Cj <br /> Building Contractor: b d I l�-ur i111.t I`din* Sewer Installer: N /A-- rc <br /> AREA BELOW THIS LINE FOR LAND SERVICE 'STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> •111f - aft. SDbats a <br /> Not \e, huvuul hao'd-cots vt <br /> �Qy}�� �� ' Fee Rec: 15a� <br /> e -"L S4+-te, ►t is -,0 _ su/1 Check#: 30k,„( <br /> Pt tvi -{o runojtd Or mil-E'-}eA b4 4I1 12°2y <br /> N <br /> l!'ZZ22 x r- �_� <br /> Date of staff site visit: 1 7 Initi Is of site v' it staff: <br /> � 2 a <br /> APPROVED BY LAND SERVICES OFFICIA . DATE: 2D 2 Cf'Co s m c <br /> 5 CD <br /> r ' Iffl <br /> Page 1of7 z oo . - <br /> CI <br /> Burnett County,WI Land Use Application—Rev 5/2023 ` v = N <br /> -, ,0 ram.:, <br /> z <br /> 3 <br /> 2 <br />