Laserfiche WebLink
i 2 <br /> LAND USE PERMIT APPLICATION- CAMPING-Burnett County, WI g <br /> rt <br /> Applicant Complete All Sections Below This Line O <br /> a N <br /> Permit Types and Fees:(Check appropriate box) 2 <br /> Camping Unit(Six Months Per Year) $100 1 3 Year Camping unit I $300 F'o <br /> *NOTE:After-the-fact(when no permit is obtained prior to camping unit placement)is up to three times the normal fee. <br /> *Sanitary Permit MUST be approved prior to placing camping unit on parcel 3 <br /> Property Owner's Name:SCLl\t(., C 1)6SJ t G1 Sd l„c___Ct <br /> Property Owner's Mailing Address: \(7n Stookvailive.. C sjclx_ 0\0 ss31 E 4,1 <br /> City State Zip, <br /> Property Site Address: a L{��oC ScLn�G P 11i)IlL � e co <br /> Contact's Telephone Number Cc-)a, 5(So -\DC) 0 o <br /> .21��\` <br /> Contact's Email: �j5e\� `t Gh�J m 6 iw Q.(WO L. M <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is $:11 4- k-. <br /> legible and your email provider will accept emails from the following address:@BurnettCountyWl.gov n L• n <br /> = (✓ rn w <br /> f <br /> Legal Description of Property: L c+ ` (�S('(\ N)2 i O ( �3 C 9(o>-7 l/ o w <br /> Section#: Town#: N Range#: ),4 W Town of: lY _ °a <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tt x system property page.* N <br /> Q n <br /> Tax ID#(1-5 digit number;found on tax statement): 4RC<) 7 c <br /> cro <br /> Sewer Installer: 5,1\ie.( TT 1 ..xe.44.\s a <br /> Camper Type 0.( .Wf Make: (3 LU Model: J IF\.€1,0 Year: , (:X p 1 Q <br /> cn <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 7 o ii <br /> o <br /> D M-t-t-F- W. St-E-Poac eS l'''°° <br /> �_ <br /> l)C Q.er be. Cot\nee- d +0 Sad, -6-ri Sys-tkri a, a--fivers z —1 <br /> x <br /> (D 1"0(CI;tn1 -611C 'I S GLA 4D 5-e.fl/lUSZI lOy Yii I OD21/ -.c <br /> Fee Rea <br /> qDate of staff site visit: 122/ZOZz7 Initials of site visit staff:kT a Check#: <br /> on <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: (/ J Z[72/ m <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF s: M <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 4' E <br /> - o <br /> Pig 0 <br /> Page 1 of 3 L <br /> Burnett County,WI Land Use Camping Application-Rev 12-2023 <br /> I <br />