Laserfiche WebLink
r- <br /> LAlr ll U NE FEKIVll l AYYLIt-A I WIN -Burnett County, W l a <br /> Applicant Complete All Sections Below This Line <br /> o. <br /> A <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> ro <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 O <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to AccessoryStructure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> eck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 c• <br /> 0 <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 /> " o <br /> Property Owner's Name: <br /> 0 <br /> Property Owner's Mailing Address: (L NP 55- ( 3 a <br /> City State Zip <br /> Property Site Address: W C <br /> Contact's Telephone Number: �51_ .2 S-- - '90 7 o a <br /> 11__ d <br /> Contact's Email: �Yl r [l s h-e- Q 'l eap- <br /> Legal Description of Property: a L p.lti ( o <br /> Section#: 2'2 Town#: YO N Range#: f�a Town o£ 14:rV__0 E-{ <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach ti systpm property page. <br /> Tax ID#(1-5 digit number;found on tax statement): V 3 � �)/) <br /> Proposed Use of Structure/Additi n: �/ ' �0, c <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) C7 <br /> Building Contractor: T( /a r� Sewer Installer: cxi ,hz <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY �J <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> • C.o�s�� v Shfere �-o.�.e..�„ <br /> T(� <br /> Fee Rec: �`J <br /> y Check#: <br /> i q � <br /> Date of staff site visit: 6' ` Initials of site visit staff: a <br /> APPROVED BY LAND SERVICES OF CIAZ VDATE: 3-—`--201 1 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF03 <br /> y, ttt li <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> n <br /> Transcendent: - Page 1 of 4 C ® r� <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 �� <br />