Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Please, check appropriate boxes)' <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 Structure (Garage, Shed, etc.) $150 Addition/Alteration to Accessory Structure $150 <br />Accessory Structure (Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br />Driveways/ & Campground Structures $125 WI State Statute 59.692(ly) Structures $350 <br />Filling/Grading $150 Boathouse $500 <br />Six Month Camping Unit (One Per Year) $100 Permit Extension (1 Year Extension - Allowed Once) $100 <br />*NOTE: After -the -fact permits (permit aquired after construction has begun) may cost up to three times the normal fee. <br />*Communication Towers & Signs require a different application form; see corresponding application, and fees. <br />*Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: 4! /�Z v h <br />Property Owner's Mailing Address: Se7 S r Address:/ rt� SCJ <br />/ City /� State Zip <br />Property Site Address: ` 7 r9 JG j i r i %T c lf� ILL -4 --E <br />l /v� <br />Contact's Telephone Number: �� / _ �� S 3 —r �F7 <<' w� y <br />app G <br />Contact's Email: %(%%! O 1s 0 " U f 3 - <br />Legal <br />Legal Description of Property: C ,(` �'a , oT /� _ 6�Z i/ 7 1 <br />Section #: I g Town N Range #: W Town of: <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br />Tax ID # (1-5 digit number; found on tax statement): ';y 7 �/d <br />Proposed Use of Structure/Addition: }7 G c*i f l �a d ,'n <br />Anticipated Start Date: -3— (Home/Cabin: Commercial Business; Bedroom; Deck: etc.) <br />Building Contractor: Y % G1! tL GSewer Installer: a S4/_ <br />Pn <br />Pr " i ,. 4S <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT ISSUBJECTTO ALL CONDITIONS LISTEID BELOW: <br />it 4-, `�`1 " �e S � 6 b 2, <br />4S <br />Date of staff site visit: Initials of site visit staff: <br />6A-7, A—) 2 — I<e <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE: <br />UPON APPROVAL: APPLICANT MUST POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page 1 of 4 <br />Burnett County, WI Land Use Application — Rev 3/2018 <br />6 <br />G. <br />C <br />� I I <br />Fee Re <br />1Xe.� #$.550, <br />o ec%-(A-4 rco--k t1( <br />r <br />0 <br />m nnh <br />n <br />co <br />D, <br />z <br />t Age <br />Q <br />m � <br />m <br />d <br />a <br />�,::3 <br />a <br />�W <br />C>6 <br />\ <br />� <br />r <br />o <br />o <br />(0 <br />o <br />� <br />I <br />o. <br />� <br />^1 <br />v <br />tA <br />o <br />0 <br />a <br />d <br />w <br />m <br />b <br />0 <br />_ <br />o <br />w <br />—T <br />7 <br />DC <br />�° <br />� I I <br />Fee Re <br />1Xe.� #$.550, <br />o ec%-(A-4 rco--k t1( <br />r <br />0 <br />m nnh <br />n <br />co <br />D, <br />z <br />t Age <br />Q <br />m � <br />m <br />d <br />a <br />�,::3 <br />