Laserfiche WebLink
v <br /> LAND USE PERMIT APPLICATION— Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 0 w <br /> Permit Types and Fees:(Please,check appropriate boxes) a 00 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 —.., <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Y <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 E <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250t .V.-- <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 °. <br /> qv <br /> Filling/Grading $150 Boathouse $500 U <br /> v <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> Iv• <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <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. "' <br /> z <br /> 0 <br /> Property Owner's Name: 0 4.4..)- PA r9 x- G1.AA) o L3 <br /> o <br /> 0. <br /> Property Owner's Mailing Address: Qc:5 cievs3 S'3 SO p•L!1p-oiCi. , 5 k-e '3 z n <br /> City State Zip ci <br /> Property Site Address: ..St to O SIC- - -. ZS o67 <br /> to <br /> Contact's Telephone Number: 1 (,4; • (o 5 b• - r3,3, el( " <br /> Contact's Email: N I fk <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b Q <br /> legible and your email provider will accept emails from the following addresses:@BurnettCounty.org and E. <br /> 00 <br /> @BurnettCountyWl.gov o tv <br /> Legal Description of Property: Leik 3 G5 -, U1-..P2,7 (i p se 5'• 0 <br /> Section#: l' Town#: 41, N Range#: I j W Town of: ,Sw 1.5,5 c, (X) <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> N o x <br /> N d <br /> Tax ID#(1-5 digit number;found on tax statement): ( ,(d N <br /> ti <br /> Proposed Use of Structure/Addition: (.c ' ' r. ' S' <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ... ci <br /> '""•-• ip r <br /> Building Contractor: Sewer Installer: <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 014(4 alf 5e..-i-beaks <br /> I VUT 40 ukll `kr huuff.Gl/YL Y oi0 • Fee Rec:41 <br /> v Check#: e <br /> Yisir- <br /> 7. <br /> c—J � J <br /> Date of staff site visit: !I 17 2Ol3 Initials of site visit staff: T <br /> ��rnrn�? ▪ n <br /> tffl <br /> APPROVED BY LAND SERVICES OFFICIA : ATE: it � 2L 1 : .o7 = <br /> rn 57 <br /> C <br /> A <br /> Pagelof7 ° `� o <br /> Burnett County, WI Land Use Application—Rev 5/2023 05 18 14. <br /> �• � w <br /> ng � <br /> m j <br /> Jj tit <br />