Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI 3 <br /> Applicant Complete All Sections Below This Line c w <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> X Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 g --- <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,.N O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ‘14 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 so <br /> d <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < , <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 — <br /> Filling/Grading $150 Boathouse $500or <br /> Solar Panels(Stand alone or roof mounted , <br /> $150 Permit Extension(1 Year Extension-Allowed Once) _$100 E `41 <br /> Ev <br /> *NOTE:After-the-factpermits ,<(permit acquired after construction has begun)may cost up tothree times the normal fee. ,� <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. 2. � <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. �` <br /> z <br /> Property Owner's Name: ►'Y) IL 14 At i t Amy SC- }Z A t Y -n (V n <br /> Property Owner's Mailing Address: 1 17 04 'tQe/1 vQN U -v tues€ + LUI. 5 4 of b. ? I <br /> Q <br /> City State Z'pr K 'J <br /> Property Site Address: W e..S,% l.Av ?BL!> L J 0 kut ,s.k q < 7 li <br /> Contact's Telephone Number: 'B I I t-Ck tit Sgh, ? (5—5 b k-2.A3 c <br /> Contact's Email: irct d • Pet e rs a&,w j fMv-‘11 a e b ►,l o <br /> **If staff has a question about this application,you will be contacted via e ail. Make sure your email address is '— <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and N °� <br /> @BurnettCountyWl.gov - <br /> Legal Description of Property: &L. Gov LOT 1 C LO I ( lqq I—581 o N <br /> ^. <br /> Section#: 3 5 Town#: 0 N Range#: l b W Town of: D 1a t\LIAIL pp� <br /> {V <br /> *ANuch udditionul page if needed for lengthy description OR attach acaln•of the deed OR attach tar.rrstem property page.* VJ � <br /> Tax ID#(1-5 digit number;found on tax statement): 1 3 I 13 1 ( 0 C7 <br /> 1� <br /> Proposed Use of Structure/Addition: �Pikt Ho Ywe f LA 1��J " <br /> (Home/Cabin;Commercial Business:Bedroom;Deck:etc.) ' eN <br /> Anticipated Start Date: M 16.7 zp Z 1 <br /> Building Contractor: c e k�� c..90. 7 Sewer Installer: WY-OS-CA ij 54v' / f t !( p W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> (ARO- akt .Yk-HCafrk-5 <br /> ® NA)f1l1ia no/. 4 mad -5 I. orn s der �t l 2� -a7 <br /> aDV <br /> = Fee Rec: <br /> c Check#: l l IS g <br /> Z reil 1ir5ar et n5`� u c4n) <br /> o <br /> Date of staff site visit: 2 'Z 202 7�/ Ini 'als of site vi it staffr <br /> • <br /> �n <br /> 5 6— € <br /> APPROVED BY LAND SERVICES OFFIC DATE: 2 /3 ZU t;4 <br /> rn <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF R CO w <br /> Z i ro <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT . et = c=, M <br /> o o <br /> Page 1 of 5 `‹ ' <br /> Burnett County,WI Land Use Application—Rev 3/2023 y 0 <br /> 3 <br /> s <br />