Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI a r b <br /> Applicant Complete All Sections Below This Line a <br /> CD I <br /> Permit Types and FeestPlease,check appropriate boxes) <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 CD <br /> , <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 <br /> 'Zc Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 �'N, <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° v <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 • <br /> Filling/Grading $150 Boathouse $500 a. <br /> v) <br /> a -.Ns <br /> 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. `• <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. a "" <br /> z <br /> o <br /> Property Owner's Name: 6 v; , A. MAI Le-fr...- �)0 i..K-t.A-, el ow-r '� '— <br /> yy (� 'L , y�' °n Z b <br /> Property Owner's Mailing Address: Li I ph 1( S l- +- NJ (- i�D 1"` 5 So�' e w. <br /> City State Zip ° "' <br /> Property Site Address: LD <<' Co(ti/l p(,lk a Pi , . N <br /> • <br /> Contact's Telephone Number: U S 1 3 S`( &( 0 ° <br /> C7 <br /> 1 % <br /> Contact's Email: CIt;c.k---r.d off 2Z @ ())*AAA1 . C-oe. <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 followng address: @BurnettCountyWI.gov 0, °0 <br /> IQ <br /> Legal Description of Property: <br /> tDOI r\-'I-tr �c ( d <br /> Section#: S 2 C Town#:i 3 it N Range#: R-I It lA) W Town of: 1 LIh o E. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* v) <br /> Tax ID#(1-5 digit number; found on tax statement): 3 2 Li'1 f `n . 5 <br /> . o <br /> Proposed Use of Structure/Addi ion:/ S k-e Cy 12' )(2D 1 H <br /> Anticipated Start Date: 7 I( I 2`-f (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) S <br /> = 3 <br /> Building Contractor: Sewer Installer: y <br /> w <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: opo <br /> c 10-Qt1- all fie,-I'bu k-s <br /> n <br /> NA- k0 Ve abl --or 1 le\wrn I -lean vo <br /> Fee Rec:/57 — <br /> ° Check#: 37 23 <br /> r. <br /> r <br /> -C <br /> c <br /> Date of staff site visit: (0'Zr7�2q Initials of site isit staff: �r�T U5. `- COrz <br /> r <br /> (?-.---,„ <br /> 7 c CAD <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: (Q izip/ o. q y n , <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF w 2 V <br /> F6 frill <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 ` <br /> Burnett County, WI Land Use Application—Rev 04/2024 <br />