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 I IBunkhouse $250 <br />Driveways/ & Campground Structures $125 WI State Statute 59.692(ly) Structures $350 <br />Filling/Grading $150 lBoathouse $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 aqui red 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: i K I &ORO -/CEJ � % 90l�oili(2 S <br />+ <br />Property Owner's Mailing Address: 4/�W 5fY06 <br />l jj�� � City State Zip <br />Property Site Address: 3008 9 44 AJ .Va � JC �Jhnl t /? �., LJ 1 s463 3o <br />Contact's Telephone Number: DOtGdi 2 �G►_jtJ PAig fCtc Soda'C�g3v <br />ZC.'cOc:n t CIC v��¢;1 Gary ra-7/t3 1ci3 <br />Contact's Email: i eG<v1C-pa P . / jQ � tgO / <br />Legal Description of Property: M j o4 E 4Ja i/%(', 1 A J J t J 5 O /'j �'" n <br />/ct t Le' f 3C <br />Section #: C21 Town #: til iM N Range #:_W Town of:�tl r S S <br />*Attach additionalpage 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): 62,2 10 0� <br />Proposed Use of Structure/Addition: S Wdzq �L1 C�:rl e� C4,6t l./ <br />Anticipated Start Date: -S CIO—, 1 c SO 18 (Home/Cabin; Commercial Business; Bedroom; Deck; etc.) <br />Building Contractor: �•4,;sz+CtAtri F.//ll'lk1 Sewer Installer: Ht:,,c1 K t 'n 1 <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />I', f)eduty-� ��k S 6�� �, � J; o s <br />hly-) '/P a� <br />Cj- M,\ ki W �Y- <br />a,� i 6Vl o �� �''�� al I ewe c9: \,/A �1 1 V) <br />o <br />Date of staff site visit: Initials of site visit staff: <br />PERMIT APPROVED BY LAND SERVICES OFFICIALeTMMUST <br />-- — - DATE: q �� <br />UPON APPROVAL: APPLICA 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 />r <br />b <br />IVA <br />I?r <br />1X, <br />Fee Rec: 300 <br />