Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI ro <br /> Applicant Complete All Sections Below This Line 5" c A <br /> Permit Types and Fees:(P/ease,check appropriate boxes) <br /> CD <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <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 4 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 Qj <br /> o b <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c i <br /> ( Filling/Grading $150 Boathouse $500 \` <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 9 A`NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. w <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. -og i <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o • <br /> z <br /> Property Owner's Name: V�c_Aot . a Q�-r 5 - ,��. ti� '" o <br /> 1 i °o 79 V.� <br /> Property Owner's Mailing Address: bt 2..6 \e CIS ct�t V t e�` '6C. S' ,%p�u` �j4 5,5 I Cl� <br /> City State Zip <br /> Property Site Address:2q 13.5 54a o 0.A -. �0.v�b t t_c-L v.)I $J-1.-&- Q < N P, <br /> Contact's Telephone Number: 6% 2 5 le ! 25 b 91 . o <br /> n <br /> v <br /> L co <br /> Contact's Email: N( i t a \I cj% +M�ck VN% , C.0 M <br /> **lf staff has a question about this application,you will be contacted via email. Make sure your email address is N •v <br /> legible and your email provider will accept emails from the following address:@BurnettCountyWl.gov =. `70 N <br /> Legal Description of Property: 6 i !2 \ IA W L1 G- W 0 F let W-c' 6 EX o (v <br /> Section#:SD et Town#: Il-4 i N Range#:'4( , W Town of: 0 0.cA a Y\a <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* � cn r° <br /> Tax ID#(1-5 digit number; found on tax statement): /;t� /,/�j 1 <br /> Proposed Use of Structure/Addition: t;GiS CPA k4:::•1.L'& `(10 e._. -i Q W <br /> Anticipated Start Date: 5-4 3 -a 6.2.y (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 0 <br /> Building Contractor: Vic_--Cd ‘6%....,OV'iSSf MWIMIS Sewer Installer: iet 7, 0 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 74 <br /> ffife-F all <br /> f duc,k-s <br /> m <br /> n <br /> rc,„,„.4,0_ u.y, insecc--ibi- . <br /> m <br /> ,,, <br /> � Fee Rec: :a <br /> ° Check#: fcr j� <br /> C Fp1t cu bat e alre >lLell4- restu,i►re rriz r-f-3 <br /> p. <br /> m <br /> n <br /> �� m <br /> Date of staff site visit: 5`16I�"1,I Initials of site visit staff: `- Gt L r- <br /> a <br /> APPROVED BY LAND SERVICES OFFICIAL: �� � i ,DDATE: 5/26P z 2 / 0 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT w c4 <br /> Page 1 of 5 m ffll <br /> Burnett County, WI Land Use Application—Rev 04/2024 <br />