Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI g <br /> a. <br /> Applicant Complete All Sections Below This Line g N� <br /> 0 <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 <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 o lb <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 r.- c <br /> Filling/Grading $150 Boathouse $500 o P <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 v' <br /> 2 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. P <br /> *Communication Towers&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. t-. D. <br /> 0 <br /> Property Owner's Name: a +Z C- p 1 <br /> P m M►�_h� e I w- _Jean I n I -a. 14 <br /> Property Owner's Mailing Address: c: r] t(�±E- lc ad 35 0gj-a' '\ 1 <br /> City a e F. <br /> Property Site Address: Up h 1 f tat 1 L I id e r n ess R Li Par -t-.. /4�} <br /> C <br /> Contact's Telephone Number: `7 15 -F't,t, - 6 a r7so "� o a <br /> n/ Nd <br /> Contact's Email: L,�)h 1 t etc(' I u.)I 1 C1-C r rle5S � h 01-(C/LI 1 • CO nm • .1 <br /> .1 <br /> Legal Description of Property: I n C\LtClt'CAIN <br /> o a <br /> 7 <br /> Section#: c� Town#: 1 HQ N Range#: J(o W Town of: c_ka_1C[an G( o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): ‘Z ! 3 ~ <br /> -� x <br /> -3 <br /> C.or11 <br /> Proposed Use of Structure/Addition: P 0\ Yl Y-O LL C slyL) O I-U✓e. W f <br /> Anticipated Start Date: ►�1)m elt c--e, Home/Cabin;Commercial Business;Bedroom;Deck;etc.) (\ (V = 5 <br /> Building Contractor: Ai/A Sewer Installer: — H O <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 1 Vv <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> A r z � N <br /> 6 Fo//ota 4// �m � oHs � CO- z(-- 1o, s -.0 <br /> z 7-rn S ge. PI C e-dS 7b !De__. Al o O'-1 C_ y /%/�Z14 42 <br /> it 1 <br /> la h'Ny .de_ I 1s /�4 coA// E 4 & 7 ( S/ <br /> t 4 '/7. <br /> Fee Rec: IZ,.50c <br /> N Check#: $'/9 k <br /> Date of staff site visit:6 -16J� C <br /> de' 6) Initials of site visit staff: hi._ ��t- m <br /> r <br /> osA22. / zAPPROVED BY LAND SERVICES OFFICIAL: DATE: rn rII a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF F, °W n 0 <br /> SLGNED PERMIT APPLICATION IN PLAIN SIGHT o o ^� GI <br /> 7' Li..‹ N ,:: <br /> Transcendent: - Page 1 of 4 x § <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 1/2020 <br /> rm <br /> -1 (1... J <br /> ›- <br /> 4 <br /> b <br />