Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County,WI g ro <br /> Applicant Complete All Sections Below This Line <br /> a <br /> Permit Types and Fees:(please,d►edc 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 a <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 \ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 rtV-Y`�1 <br /> Driveways/&Campground Structures $125 1WI State Statute 59.692(ly)Structures $350 r <br /> Fillin Grading $150 Boathouse $500 <br /> 0 <br /> Six Month Camping Unit One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 ' <br /> *NOSE:After-the-fad permits(permitaquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different apprication form;see corresponding application,and fees. <br /> *Items not listed above wilibe treated as accessary structures,such as:per olds,landscaping,etc r, <br /> 0 <br /> Property Owner's Name: ,� •�t c. \ �h L�1 <br /> v\ Q� <br /> Property Owner's Mailing Address: f 5 4 2. 1 LQ t-.w.i S�, .y 1n�1wlj 0 <br /> City State Zip y <br /> Property Site Address: �� 3 i�' "r• �- �•\ �''' „�{S�°hY t Wt s4l try0 <br /> ' 15 ° <br /> Contact's Telephone Number: '�.�`�- ,6 G1 <br /> Contact'sEmail: <br /> Legal Description of Property: LA, $ G S )�l , }'' (e) <br /> Section Town#: _N Range#:_JE W Town of: '0 ^,j e_ La ke- o <br /> d <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* W <br /> Tax ID#(1-5 digit number,found on tax statement): 211-I G <br /> Proposed Use of Structure/Addition: ?o c S ' S ��. 5 � o <br /> Anticipated Start Date; g 131 III (HometCabm;Commercial Business;Bedroom;Deck;etc) 9 ' a <br /> Building Contractor: 'Jr s h,�w^^c '�� ( 5 ) Sewer Installer. <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTSICONDITIONS ONLY <br /> THIS PERMITIS SUBJECT TO ALL/CONDITIONS LISTED BELOW: <br /> Not f v �e ttee / -q✓- 4 a ma o At to I7614oA - z <br /> X V�� <br /> ("lake— 5Ur° �v lmcz- f0 f�LS h4 /UOr/A pyopv�l' Fee Rec: L5b� <br /> �`' G} Check#:/Vlo <br /> Date of staff site visit: v z � / Initials of site visit sta$ // �/ a �� �v a(�O� <br /> x <br /> Q o <br /> rA <br /> APPROVED BY LAND SERVICES OFFICIAL: _DATE: <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT R ;2.3 <br /> `� it uU <br /> co <br /> Transcendent: 0 C; pPage 1 Of 4 m e rs r <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2019 M m <br /> d 3 �' <br />