Laserfiche WebLink
LAND USE PERMIT APPLICATION —Burnett County, WI00 <br /> a <br /> Ap <br /> plicant Complete All Sections Below This Line c \ <br /> Permit Types and Fees�Please,check appropriate boxes) �17 ° <br /> G <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 /> Accessory Structur Garage,,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 9 <br /> Accessory Structure mercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> G) Q <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk 113unkhouse $250 <br /> Driveways/&Campground Structures $125 IWI State Statute 59.692(1v)Structures $350 0 �\ <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 t �7 <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. <br /> b <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 /> z <br /> 0 <br /> Property Owner's Name: ..lpPr�:j OvWCU--r <br /> N a. <br /> Property Owner's Mailing Address: Zit Z. PC-C*o-- (44.,ok �t,n! 54 is e. N (� <br /> City State Zip ° w <br /> Property Site Address: 2-cj Z N Z- f9a(-Au, c C o N <br /> Z <br /> Contact's Telephone Number. 71S' � 314 <br /> C7 <br /> w <br /> Contact's Email: ki n C, ow ikj <br /> **If staff has a question about this application,you will be contactell via email. Make sure your email address is N '� <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and °U w <br /> @BumettCountyWI.gov N <br /> 0 0 <br /> Legal Description of Property: 0Gk ar (L Jcr5 icy c L&V 10 <br /> Section#: U(;; Town#: y p N Range#: I W Town of: OC O"d <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* O o <br /> Tax ID#(1-5 digit number; found on tax statement): I H g(,`b <br /> Proposed Use of Structure/Addition: Po nc,.a 1 e- <br /> O <br /> Anticipated Start Date: t=,/i (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o D <br /> Building Contractor: Sewer Installer: RAS5},.1 r,\ a 6' <br /> go <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z � <br /> � D <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> s <br /> O MECT ALL 7eT6ticK5 . CFit'Ptm— le rxOoT it DE 6ET3r4C1L , <br /> 2Q !Dwecuvt- N D T -m ExccED 3 3E1>130oatts pFi� 5Asu-Z`+-.Z 33 � <br /> (25 1Z x iC. St}ED ovo-V -ro ZE 05E1-> roR EiuwAqu HA3/TA710N x Fee Rec:'M60 <br /> PEA t-u P- Z4- 2.54. c Check#: <br /> z <br /> z <br /> 0 <br /> m <br /> Date of staff site visit: Initials of site visit staff:'->Z <br /> m s� �11�t1 <br /> APPROVED BY LAND SERVICES OFFICIAL: 1 DATE:3/6I ZoZS �`_ a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z � <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT � <br /> �Ar'7 CD C 1W <br /> M <br /> Page I of 5 < 3 <br /> M CD <br /> Burnett County,WI Land Use Application—Rev 3/2023 a <br /> � L� <br />