Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> W. b <br /> Applicant Complete Al! Sections Below This Line o• a 64%. <br /> F <br /> Permit Types and Fees:(Please,check appropriate boxes) a 0,0 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure •$200 `° ( ' <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 iO <br /> k F <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 /> I <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> a <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r-. <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 cn , <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. b <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- <br /> 0 <br /> r 0 <br /> Property Owner's Name: j\l�(C h 0 t I ,"_ )tor- \/V a I -f- —I n 0 '; <br /> Property Owner's MailingAddress: I \ ,! 5 <br /> P � a����5 �tGlf e_ I�iC ad 35 l�eb5-t�✓� 1/�' L J 4g9-3va <br /> City - ate ip P. <br /> cip <br /> Property Site Address: (`� i 1-a t 1 1 i e it 1�e.S_S L) Par .-t - <br /> D o <br /> Contact's Telephone Number: 1 5 (�(c, cl'7(v ZE �; <br /> Contact's Email: L,k.)ht te-Ic&i I u)t ICI-Ci nCSS 1 _11101'a)Cu I . co✓Yl "n T, <br /> Legal Description of Property: I tl C l Lt CI.r C/ J <br /> ❑ 0° II <br /> Section#: ?j< Town#: 1 L--ILi N Range#: f(r) W Town of: C)(,_K 1(I n,' ag <br /> o t <br /> *Attach additional page if needed Or lengthy description OR attach a copy of the deed OR attach tax system property page.* tn <br /> Tax ID#(1-5 digit number; found on tax statement): .�� 36 2-9 3 . <br /> ^ <br /> Proposed Use of Structure/Addition: C_Ct 1 r p C�Y`p Li_ Yl Ca! 5 f rU C f u ire_ vJ <br /> Anticipated Start Date: 1t'(71cctt CL-t-e, Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ‘ V e <br /> V —I <br /> Building Contractor: iV'/A Sewer Installer: <br /> © WAREA BELOW THISLINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ---z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: (T <br /> r z A —�O <br /> ,0�/t/ow a// cox c4oaS ►...& G4P- ZI-/O. o <br /> g T ►s 5/' kfr.e k 4,e. r"o '�- e,e/by /o'/zoacz 7 n v dHy t).'' <br /> /- e_ /f i . /H74 cewsp/IqK« 14_ size I? e-A, a <br /> - Fee Rec:I2,SUO <br /> Check#: F/? <br /> Date of staff site visit:C Initials of site visit staff: r <br /> Y <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: /� 02 V J.L. jj <br /> UPON APPROVAL: APP ICANT MUST POST COPY OF co a <br /> c <br /> SIGNED PFRMIT APPLICATION IN PLAIN SIGHT .. 0_ mi <br /> CD C <br /> Transcendent: - <br /> Page 1 of 4 ,� <br /> Laserfische: - Burnett County, WI Land Use Application-Rev 1/2020 a R1 <br /> b <br />