Laserfiche WebLink
CD <br /> LAND USE PERMIT APPLICATION — Burnett County, WI Cr <br /> ro <br /> rn N <br /> Applicant Complete All Sections Below This Line41 <br /> Permit Types and FeesjPlease,check appropriate boxes) p C7 <br /> w <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> � O <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 /> p <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. `D <br /> o ' <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> Property Owner's Name: /�� %e A 13/J6.Z Aj/J f�1lt✓C1 T ,C 4l&e o <br /> _ a <br /> Property Owner's Mailing Address: 1&a z9,tlf m). ,Sr. A)z,) 4,U,)0,1L:712 <br /> City State Zip <br /> Property Site Address: 3� Lo i aQL AS�l2�; ISL�J�t) c��- cy <br /> O N <br /> O <br /> m <br /> Contact's Telephone Number: 6/ - 79D -0.0 71 a <br /> C7 <br /> w <br /> Contact's Email: y' t"4 Ole;' <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is �„ b <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov °Q <br /> Legal Description of Property: ,CD i S 39 r'�/, T�CAS�2�SSL/�✓J/1 iY� To <br /> C7 .Z <br /> —D <br /> Section#: I Z Town#: 10 N Range#: 15 W Town of: J'a L4on <br /> —6 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* = o <br /> Tax ID#(1-5 digit number;found on tax statement): Q&11F;f7 911 Fg, N tj <br /> Proposed Use of Structure/ Dd,iti X J i: T �C 7 D2 EL N �1 <br /> Anticipated Start Date: Odr�-�� (Nome/Cabin;Commercial Business;Bedroom;Deck;etc) <br /> Sewer Installer: A)Z4 En <br /> Building Contractor: ]�' 0 b <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> No} 40 IQe cA <br /> A L -�-tk.hk �i a AT 6C SkCLk rCd tr-4ti <br /> fell^ � SIIIZ(�ZS m <br /> A4 <br /> J �,{� L (, � (� r�7 q,,,l($�Yl) � Fee Rec:�5d <br /> 5) Lo. q0 U't� Lol y I -V k corm; 1e0 t -414 Q �j�'fl�le �(Jl r r- Check#: <br /> �nt+�' 12-C25, Dr �ora5Cby 0, M . ux9_8 �.rjelor by <br /> m <br /> Mb\)f,d At wUA-4 sk+t,ac k 40 4-W <br /> Date of staff site visit: q Initials of site visit staff`9( T-r B > <br /> Cn <br /> CD/I b <br /> APPROVED BY LAND SERVICES OFFICIAL:11/0 1,b DATE: <br /> Cn c <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT r <br /> CD <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application-Rev 04/2024 �--� <br />