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 />C: <br />Dwelling/Principal Structure $300 <br />Addition/Alteration to Dwelling/Principal Structure <br />$200 <br />Commercial/Industrial Structure $300 <br />Addition/Alteration to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) $150 <br />I <br />Addition/Alteration to Accessory Structure <br />$150 <br />Accessory Structure (Commercial/Industrial) $200 <br />Addition/Alteration to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk <br />Driveways/ & Campground Structures $125 <br />Bunkhouse <br />$250 <br />WI State Statute 59.692(ly) Structures <br />$350 <br />Filling/Grading $150 <br />Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) $100 <br />Permit Extension (1 Year Extension - Allowed Once) <br />$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: &_6t M ✓1 4 V_V__CrMA <br />Property Owner's Mailing Address: <br />Property Site Address <br />191461y MAton-r— <br />i b t 14-e vq 14✓e <br />Contact's Telephone Number: t) % - ZU Z' t 1 7 <br />City State <br />(; ✓-e vu.-1�S�ic , vv -T -- <br />Contact's Email: H F, 0 J- '� Z 1'7 e vi o+yyia-r I - e�y Y` <br />SS4121 <br />Legal Description of Property: 6-qc [ 0 �- <br />Section #: -36 Town #:__�t> N Range #:/_W Town of: b4V., 'd A/ <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):—7-, <br />Proposed Use of Structure/Addition <br />Anticipated Start Dater <br />Building Contractor: AIA' <br />roe r+111 <br />(Nome/Cabin; Commercial Business; Bedroont; Deck; etc.) <br />Sewer Installer: <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />visit taff- <br />Date of staff site visit: 7 � 6 —) �_ Initials s s <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE: 7- DI <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 />T <br />Cr <br />a <br />n <br />0 <br />0 <br />0 <br />b <br />2 <br />�o <br />� Fee Rec:�_ <br />(� 133` <br />rn <br />a <br />z <br />0 <br />m <br />C: <br />l� w; <br />�J <br />m 00 <br />1 <br />d <br />a"� mow; <br />