Laserfiche WebLink
LAND USE PERMIT APPLICATION-Burnett County,WI cr <br /> c r <br /> s C ro <br /> Applicant Complete All Sections Below This Line F, o <br /> a <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ( ^ <br /> v J <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 G1 n <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r. <br /> a <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(l Year Extension-Allowed Once) $100 c <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. Ilio <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- i • <br /> 0 <br /> /� 7.; <br /> Property Owner's Name: S�Q'rp p A Vk►L vQ .Tieka *11^ �t4tVQ n <br /> Property Owner's Mailing Address: a Q a 6/ S LA) -jot r fol Da fibytll` ' 14. <br /> City State Zip t � (-) BA <br /> Site Address: 5'n,14,...--4, <br /> 0 <br /> Contact's Telephone Number: 7/5 Yt C -- s,)a 7 a <br /> C <br /> Contact's Email: <br /> Legal Description of Property: 4.pT4t( C5' '\f a P 2?) i. C,p), LOT 9) N ov <br /> Section#:SO'7 Town#:C3[,2 N Range#: R 15&W Town of: 5'c u co v o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): 1 5 1'I5 r n <br /> Proposed Use of Structure/ dition: 9r6 �y 9 c (tic-�,f 6 r-.n4 c.9. ' V\ V k --�-�- <br /> Anticipated Start Date: —20 a® (Home/Cabin;Commercial Busi ess;Bedroom;Deck;etc. C7 J <br /> / 4 <br /> Building Contractor: Sewer Installer: 'PIN Q, y ('. "'"" 1x <br /> k :',:g. <br /> � 1�1-i <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: g T —K ''i. -.• <br /> ow �M�-1- pve\---k7‘clic\ z <br /> wl �'` x <br /> 6�� � l•w �15 g1 <br /> /� 0 0 <br /> �� <br /> ci3 IL- rc3t."') '.1 <br /> Fee Rec. , <br /> Check#:053)0 y ( l JJ <br /> r\/ <br /> WK.— a' <br /> Date of staff site visit: l —i�._,4'4V a of site visit staff: a- <br /> o /• <br /> APPROVED BY LAND SERVICES OFFICIA : A DATE: V"--./61.7-010)Q0 gj f� <br /> Q0 1 1e9j �/ Q �- `v <br /> '$ <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF �,'1"` C 0".9c CivcA i e� <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z 5,1 5"LI <br /> 1,,, ,-1l S ar . caw. W ctt���>~� <br /> Transcendent: - Page 1 of 4 R <r0 q-e.1 -11A-4- c, ��e)-v---- <br /> Laserfische: - Burnett County,WI Land Use Application-Rev 1/2020 < Ili x v\..6-ckwd 5,_w, ;ms s, <br /> re_ c 10 _ y(^t P) -e-v` <br /> C0V'• C—k7e-Ie 5 S,A,00 'T h v'- <br /> J S..a_rLA G-� 56 X 30 ' 5'i..e.cc '�Gw` <br /> //' <br /> ` <br /> 1.o St r-e-ti b u t 'fod-q.d r.J 6y 5 +, 4- <br /> 715.,7 15., <br /> 561 7 21° 076020 „.\.1. <br />