Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a " <br /> b <br /> Applicant Complete All Sections Below This Line co" co i <br /> Permit Types and FeestPlease,check appropriate boxes) C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 tv <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \'6"--" O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 g <br /> Accesso Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 C ~� <br /> y\\ Dec Stairs Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> Driveways/&Campground Structures 1.25 WI State Statute 59.692(ly)Structures $350 o d <br /> Filling/Grading $150 ,Boathouse $500 En i <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. `q <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. t: <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. - "" P.t' 11 z <br /> `4 <br /> Property Owner's Name: T�1 p I/vt LY S - e yi. o ` <br /> Property Owner's Mailing Address: LI t 1 G b n b i- &A G V\ M kJ 55(z3 I <br /> (� <br /> '/ city State Zip E <br /> Property Site Address: 2)0 cG p��E- ( 5 • DCLi`1��IN 1 �,, o y <br /> Contact's Telephone Number: (0 ("Z.-7 0l 0 i <br /> i rl1 a <br /> C7 <br /> Contact's Email: CAI e—iiii y -S 0 cC CWS+ ' + <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b -:;.--' <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov o °O <br /> B. <br /> (7,2 <br /> Legal Description of Property: d <br /> Section#: Town#: N Range#: W Town of: oUl. OI-V'lp m. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ") <br /> > <br /> Tax ID#(1-5 digit number;found on tax statement): i 7 DO o � <br /> j c s-�i r� <br /> Proposed Use of Structure/Addition: �L C�W\ t�` OT l S �� t -- <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) r- f <br /> Building Contractor: Sewer Installer: N 0W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: opo <br /> r <br /> z <br /> F <br /> l m <br /> -9rWS W6�C ko E%.W S 'w, 11io.�� . <br /> 1Ajff( 5 V Alb EY-w�. 40 V1,' ' \haJ \044) �t> 'r k1...Sk 't5, Fee Rec:,�t2S <br /> 0 ° Check#:Cp5(} <br /> z <br /> a <br /> 5 <br /> m <br /> Date of staff site visit: ,jL)Z't Initials of site visit staff: 0- IA gro <br /> APPROVED BY LAND SERVICES OFFICIAL: j)04l jhv i('Ii DATE•. Co''bj l,-( <br /> a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF M-rCD C.3 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> 0 <br /> Page 1 of 5 ,--�v- J <br /> Burnett County,WI Land Use Application—Rev 04/2024 <br />