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(1v) 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 />s II <br />Property Owner's Name: j O M C l It h "SD n <br />Property Owner's Mailing Address: 701 &tJJ- T -k 0 . QZa, SxfQao <br />State Zip <br />Property Site Address:[ -.45-(o 1 k?- <br />Contact's Telephone Number, 5 -7-5S' cl Q49 <br />Contact's Email: t e;rOMe- @ i h 'O 0111) <br />Legal Description of Property: <br />Section #: -9(4 Town #: 3 6) N Range #: 0-0 W Town of: P\ p -h 0 h <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): I a o 0 N <br />Proposed Use of Structure/Addition: S -6r -j— I = <br />Anticipated Start Date: i19 o d t4 l 1 ,( (Hamel abin; Commercial Business; Bedroom; Deck; etc.) <br />/� <br />Building Contractor: S NN51 �c=rI 011 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 />Date of staff site visit: o Initials of s' e visit staff: <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE:ja�� <br />UPON APPROVAL: APPLICANT M T POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Transcendent: - �LA /, <br />Page 1 of 4 <br />Laserfische: - Burnett County, WI Land Use Application — Rev 8/2018 <br />c <br />ro <br />7CD <br />3 <br />C. <br />y <br />p <br />� <br />o <br />� d <br />^� <br />f„a <br />o0 <br />� <br />J <br />o <br />I <br />< pppUJ <br />(`A <br />Do o <br />1 <br />g <br />3 <br />(o <br />b <br />z <br />P <br />r- <br />0 <br />o <br />-- <br />c. <br />m <br />n <br />o N <br />O <br />j <br />a <br />d <br />w <br />iP <br />0 <br />0 <br />00 <br />OrQ <br />d <br />y <br />n' <br />CA <br />9j) o <br />m <br />x <br />F <br />ate' <br />v <br />00 <br />5 <br />d <br />z 5 <br />f <br />ou <br />.� Fee Rec:� <br />N Check #: I UUa <br />d <br />m <br />