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(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 />Property Owner's Name: 0h v C f - <br />Property Owner's Mailing Address: 259/.5 / 2. Al,,, e 6h uo :.1 r h N <br />` City State Zip <br />Property Site Address: oC••� 4-,5 � 9 Ga �2f,h ?%,! Rd <br />Contact's Telephone Number:2.52" C1 Voo,'? - <br />Contact's Email: 6 AIf, Z1e�- <br />Legal Description of Property: <br />Section #: Q 4' Town #: .19_N Range #: W Town of. La leo c 77-c <br />*Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br />Tax ID # (1-5 digit number; found on tax statement): 937 7 <br />Proposed Use of Structure/Ad ition: Act e sr 7-t, <br />Anticipated Start Date: 11.5 (Home/Cabin: Commercial Business: Bedroom; Deck: etc) <br />g Contractor: Q�cA covne r, �y'�der1 <br />Building X Cy,TTpvy� 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 />J4 -A -:,r To � � L6t S��c s��be��s. L&,,In� M" <br />cq cc -i' r y\�r.�— r1 --,,&-j f> o� G <br />Date of staff site visit: Initials of site visit staff: <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL DATE: ), 0 <br />UPON APPROVAL: APPLICANT 4S/T POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Transcendent: - Page 1 of 4 <br />Laserfische: - Burnett County, WI Land Use Application - Rev 8/2018 <br />n <br />0 <br />n <br />OC <br />V1% <br />Fee Rec k— <br />x <br />D5 <br />Check #: 36Q9 <br />M <br />8hiller <br />a <br />z <br />a <br />