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 $300rAddition/Alteration <br />lteration to Dwelling/Principal Structure $200 <br />Commercial/Industrial Structure $300lteration to Commercial/Industrial Structure $200 <br />Accessory Structure (Garage, Shed, etc.) $150lteration to Accessory Structure $150 <br />Accessory Structure (Commercial/Industrial) $200lteration to Bunkhouse $150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk $250 <br />Driveways/ & Campground Structures $125tatute 59.692(1v) Structures $350 <br />Filling/Grading $150 Boathouse $500 <br />Six Month Camping Unit (One Per Year) $100 1 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: 6ainire d T 6. r` H <br />Property Owner's Mailing Address: % i1a /744 6,.4M. l Fl- S& <br />City State Zip <br />Property Site Address: a y 5a Pv Pn'f �'1 aa.[ L��,o <br />Contact's Telephone Number: Tnt,cle �101047 <br />Contact's Email: —T�y r e ri1 5et4, <br />Legal Description of Property: ou 6' k a f 4 <br />Section #: 0j Town #: N Range #: f -A5 W Town of: lac to 1 r 6 c <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): <br />Proposed Use of Structure/Addition: -149 8 �� C <br />Anticipated Start Date: & — 15 — znO r Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: �ea� m (pA3tyU,e{-1 11"IC.Sewer Installer: / A- <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PER1MIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />�c.,S�u�`7 � r o r� �f O V �=-- LO`�� 1 e.,-}•�� � c '� I— Q.v� <br />Date of staff site visit: Initials of si a visit staff: �J <br />/JVP/--' <br />a -I <br />PERMIT APPROVED BY LAND SERVICES OFFICIA • DATE: <br />UPON APPROVAL: APPLICANT MU POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page I of 4 <br />Burnett County, WI Land Use Application — Rev 3/2018 <br />a <br />s <br />Oil <br />0 <br />0 <br />a <br />w <br />0 <br />N <br />a <br />0 <br />2 <br />C" <br />b <br />00 <br />211 <br />i <br />u <br />