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 1 jWl State Statute 59.692(ly) Structures $350 <br />Filling/Grading $150 Boathouse $500 <br />Six Month Camping Unit (One Per Year) $100 lPermit 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 <br />'structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: C}/L N �✓1 eI, <br />Property Owner's Mailing Address: 53 y% Wl 'S%W3 <br />/ City State Zip <br />Property Site Address:—S,3 y % -Y -69 �3 <br />Contact's Telephone Number: (S/- .240// 7073 <br />Contact's Email: Aleto-c. A vnleo— 00 oi✓J <br />Legal Description of Property: PkT LOT 01 CS1M V 8 f aa8 L- G N OF"roWN L_# ME <br />Section #: 3 A Town #: <N N Range #: /S W Town of: '540A Lg k e-- <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)1: % 39 <br />y <br />Proposed Use of Structure/Addjtion: Po14, S{,► <br />Anticipated Start Date: 9t(�,/g (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: 44,41*4 &,'IWd s Sewer Installer:-Ve.-7e- <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />3 �g <br />Date of staff site visit: Initials of site visit staff: �6 <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: 6� 6 � DATE: <br />UPON APPROVAL: APPLICANT M T 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 />Q <br />b <br />1 <br />n <br />_ <br />y <br />c <br />a <br />C7 <br />c� <br />0 <br />co <br />J <br />T <br />T <br />b <br />o <br />M <br />0 <br />0 <br />c <br />d <br />d <br />m <br />oBio <br />0 <br />i11 <br />° <br />y <br />d <br />Q0 <br />Fee Rec: 5� <br />