Laserfiche WebLink
r <br /> • LAND USE PERMIT APPLICATION - Burnett County, WI a gb <br /> ' Applicant Complete All Sections Below This Line ' N <br /> Permit Types and Fees:(Please,check appropriate boxes) ,/� i <br /> Dwelling/Principal Structure $300 J(�Addition/Alteration to Dwelling/Principal Structure _„ ` <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 �'"(� <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 0 <br /> On g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk ► Bunkhouse $250 '' <br /> Driveways/&Campground Structures _1 % WI State Statute 59.692(1v)Structures $350 ° r <br /> Filling/Grading $150 Boathouse $500 o 111, <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 <br /> P <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. c <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. L\ <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> Property Owner's Name: Tr-a.,c fs-r1 S en S o h <br /> ^� x y 5 4'3 .,v\ ram" 1 <br /> Property Owner's Mailing Address: .� 3 Ci ILA Lt.) cI . 0,,it.-'I r MA; °o W <br /> City State Zip <br /> Property Site Address: J ()b a G LA- -S l� R. 0 et_r1 �7 iz-.L.y ( a' vts v, <br /> � 35 1 y�� < <br /> Contact's Telephone Number: a i <6- ,s -7(�" ('' I`O r <br /> a- <br /> Contact's Email: `� 0-1'1 S "I . t't LL'✓L1 . Lint\ 9 " >'�e t I o c d <br /> Legal Description of Property: S -e- e ��.. 7IA-�` <br /> s <br /> Section#: a--) Town#: 4-1I N Range#: ( S W Town of: s Cu ( S S o o a <br /> *Attach additional page i neededfor lengthy description OR attach a copyofthe deed OR attach tax system property page.** tr., <br /> PS .f S Y Y P P tl'Pg C7 <br /> Tax ID#(1-5 digit number; found on tax statement): (p s— - 6Cg" <br /> Proposed Use of Structure/Addition: 0 ` — Il e�2 f i.),.)/ C-Y," c C' c'�*- i y y <br /> Anticipated Start Date: 1}-p if,1 I Mel tLy )ch; t�(Home/Cabin;Commercial Business;Bedroom;Deck;etc.) N �e <br /> Building Contractor: I i�l/�� I Sewer Installer: ) fA v d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY v , <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured Z <br /> home additions,and bunkhouses.** � V\ <br /> g c9Glia UDC isjo %' 42 sue- /°.P/�' � ip' q <br /> b.e.4p.Arf'.0, r / �J/ <br /> Fd/10� M ►titt�4 � U1v�eAmev►�. SGe, 4:AdteI ew14/!S, <br /> laFee Recr' 6 <br /> / / 4/ p,7; Check 270Date of staff site visit 3/81224 Initials of site visit staff 4- C� L r 2PC/� <br /> i c�.if 3271 <br /> pz <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: g ZO_ __)._„LJ <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF r a - H <br /> 41 w co 11. - C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT � a c 9 <br /> Transcendent: - Page 1 of 4 M -8 S <br /> Burnett County, WI Land Use Application—Rev 6/2020 Al, <br /> \Lr <br /> fisc • - D► 1� <br /> Vie_ fm� .1Qvi my G>^ .11 s,Ly ok Y pi 'e, <br /> c,,�IIu-�� LL isyI�oh cap+ <br /> 1141�112, ei7'70�Iv 1 i elan 51DI� 9t9t$ A hi.2,P ct tsAo'j liwltt i L J <br /> s <br />