Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI b <br /> Applicant Complete All Sections Below This Line <br /> CD <br /> Permit Types and FeestPlease,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 <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 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> X([i�7,��k,,Stair,/P,tio/Retaining Wall/Sidewalk Bunkhouse $250 °riveays/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 0 <br /> Filling/Grading $150 1 lBoathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 w. <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. �J17 <br /> �o <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. <br /> o (C <br /> Property Owner's Name: F�tMlC.i L $ SUSA,J L <br /> /D� <br /> 0 <br /> 0 <br /> a <br /> Property Owner's Mailing Address: � �t"we/ A? Je-1-1e/ U.117 5YFL3n <br /> City State Zip ° <br /> Property Site Address: ,29'? .S ��C 0-1cJle,- ed, o <br /> c <br /> Contact's Telephone Number: 71S"733-e0j Z n <br /> d <br /> Contact's Email: <br /> **If staff has a question about this application, ou will be contacted via email. Make sure your email address is N <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov °Q <br /> 5' <br /> Legal Description of Property: i01- / Or ;4 74-!� &L4Z:;0 A✓ 6o.'1- Zvr 7 SP <br /> s <br /> Section#: 3 Town#: N Range#:�W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> o w <br /> Tax ID#(1-5 digit number;found on tax statement): 3536 1 <br /> 0 <br /> Proposed Use of Structure/Addition: j .(G j,,) 54n,6 16y—. y ✓! /tlr iiwriat,- <br /> .� <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: PA nj /��L?i#V,it'" - Sewer Installer: /1///� Q a W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> � /� / e yo cr�iJ� e�uHcd 6y /Z / Zoz m <br /> Q,�ett/u^ day /1 dS r P / s Y < <br /> �1 e gllow 6� r�ul'l� iN ie ���� ocs��rd�► <br /> o >M Fee Rec: <br /> 22- <br /> ° Check#: 06?5 <br /> z <br /> r <br /> n <br /> m <br /> Date of staff site visit: h&z, Initi Is of site visit taff: i C ca ® ll�uU <br /> APPROVED BY LAND SERVICES OFFICIAL: ATE: I 7 Z 5'` c <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o= r o <br /> � z o <br /> tV <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT �_-am <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 04/2024 <br />