Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI r <br /> a <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 f0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 9 <br /> AccessoryStructure(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 $1501 lBoathouse $500 ° <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fad 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. r <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> z <br /> Property Owner's Name: <br /> Property Owner's Mailing Address: -�G-X ( n WT o <br /> City State Zip a <br /> Property Site Address: 2. <br /> Contact's Telephone Number: (1 i5 ) 9 alb -1 3,9 1 "- S h c, <br /> d <br /> Contact's Email: 63, t).ons+ `u IotA G� �ot,___ - Ao J i CDC <br /> Legal Description of Property: o <br /> Section#: Town#:__(4_D N Range#:__1i4W Town of: S50-04 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> rcfn J S 0 <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: c5.�a �� ,• �o �n o r�t � `��c ���{�'J nr <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) � C7 <br /> Building Contractor: t) Sewer Installer: -3 <br /> . <br /> AREA BELOW THIS LINE FR LOAND SERVICES STAFF COMMENTS/CONDITIONS ONLY D <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> a4 <br /> 143 <br /> � 4'oXrY� �h] 0DYE _ <br /> 0 <br /> 4 <br /> y Fee Rec: <br /> 14 <br /> Check#: y �^ <br /> d <br /> r� <br /> Date of staff site visit: Initials of site visit staff: r <br /> — a <br /> APPROVED BY LAND SERVICES OFFICIAL• � DATE: /a�S/ 1 � <br /> UPON APPROVAL: APPLICAN MUST POST COPY OF <br /> SIGNED PER <br /> MIT APPLICATION IN PLAIN SIGHT oa CD <br /> Transcendent: - <br /> Page 1 of 4 n -� o <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 C: /� <br />