Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI - <br /> Applicant Complete All Sections Below This Line a- 41 <br /> a ' <br /> Permit Types and Fees:(Please,check appropriate boxes) Y d <br /> Dwelling/Principal Structure `=$300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ �O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 2. <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o <br /> / Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 I <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 (. Illk <br /> o <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. --o <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. t- <br /> Property Owner's Name: `'f ° <br /> P rtY N11chc� ei ,.J��n ��a ( +-zl n� .� z P <br /> Property Owner's Mailing Address: c)17 ti as S to.-t-e "Plc ad 35 Webs-tic V✓Z 5 Ogg;a <br /> \ City tate i = n <br /> Property Site Address: U%h 1+-e t a t I Lt)i Id e r n ess 1 U Par K- L,o-t-- 4/3 <br /> < - <br /> Contact's Telephone Number: '7 15 - '(c(c' �'�0 r7� - 0 <br /> o <br /> Contact's Email: Wh► te1l / u 1 tc.,-c r r)e55 1 h6fi Cu I . CO in ---������ <br /> Cl M <br /> •1 <br /> Legal Description of Property: 1 rl C 1 Ct d r-el N <br /> 0 <br /> Section#: 22j c Town#: 1 1-40 N Range#: J(D W Town of: CQ.K I a n G( w u. ^` <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): 3 6 a?3 <br /> Proposed Use of Structure/Addition: C0.rn t'C ro tt nd Si—r(.) C ore w ° pi <br /> Anticipated Start Date: p(1)f11eat G(-t-e, Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Cj <br /> Building Contractor: /v/A Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY A , <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> tl Fo//m w e /l c.vpkc44A5 -c_ COP-21-/oe z S 0 <br /> 01h' s/V- ii e s -74) 4 e- 440c6z4ej /6/%Z.K w <br /> m /Jan (AA S/Ze, l 1 �73• <br /> Fee Rec: /Z S��v <br /> Check#: 8W <br /> Date of staff site visikr � (9 Initials of site visit staff: '` _\ <br /> J l.._J <br /> • r- <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3 Z7/7.c9 Z 4 • o. <br /> wW 0 <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF D` <br /> Nil. CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT Q N �, <br /> Transcendent: - 0 <br /> Page 1 of 4 �1 <br /> Laserfische: - Burnett County, WI Land Use Application -Rev 1/2020 1 j <br /> ro <br />