Laserfiche WebLink
• <br /> • <br /> LAND USE PERMIT APPLICATION—Burnett County, WI w N r <br /> a <br /> N <br /> Applicant Complete All Sections Below This Line 5' 0 <br /> CD Ia <br /> Permit Types and Fees:(Please,check appropriate.• . 1 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 '"-t. °:1 <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 aim Bunkhouse $250 <br /> Driveways/&Campground Structures MO WI State Statute 59.692(1v)Structures $350 r- <br /> Filling/Grading X 050 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 v k <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. 7 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. t— <br /> o V <br /> / n o <br /> Property Owner's Name: 5/even 1 4,-so..) / it)'e^,"/ L & c� ( ' <br /> Property Owner's Mailing Address: 'co)� '(c ( A � WVJ_'-tC( LLi 5q 8 • <br /> 4 <br /> City State Zip E.. �, <br /> Property Site Address: <br /> 0 <br /> aContact's Telephone Number: 7 i S- i C'L,- ).$'S a <br /> d (t <br /> Contact's Email:_ a <br /> Legal Description of Property: CM <br /> Section#: A f Town#: 3? N Range#: / 7 W Town of: L.VI Cciel a <br /> g <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ET <br /> 0 <br /> Tax ID#(1-5 digit number;found on tax statement): /O 10/ CA <br /> H <br /> Proposed Use of Structure/Addition: 11Q ' e H <br /> r` x <br /> Anticipated Start Date: /11 AO;LC (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) EI, <br /> Building Contractor: jk,,,e, L5s04...J Sewer Installer: ` ((e icL,- 5r 0 -t L. H j <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT ISSUBJECTTO ALL CONDITIONS LISTED BELOW: o <br /> (� <br /> • I' lata c i\ k b--f a6--k- s t c e. ' e-A---b&QK .c,k1c293 Sa 4.'F&e rn 7 <br /> p <br /> s'vdke VA' k Ike bLoIA-OA co-ccl %.4 Z1-11 -fix id A 51. <br /> -• We�Vtin Aws� Jot- P <br /> • (1'le-e'drIVet,Ja OV'd\h0.r\ke c- tktCewkehZ'S by 'qty t ' <br /> k clt l • c\.--1-4., / chre Y 0.Ceck'�O 0.eeaw..0.44'e a 30 405t'AY _ re Fee Rec: :XXJ— <br /> •1- � �17 r •r"' 1 rt.1e1' Check#: 3 a(o� <br /> 1o��'JQ t a,o�O' / r7 <br /> State I sli.e vrsi . Li i 't I Initial of site visit staff: tta <br /> z <br /> d <br /> APPROVED BY LAND SERVICES OFFICIAL\ALATE: y aid 7 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OFA <br /> Ififil <br /> ,? a y <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT r N CSS <br /> Transcendent: - Page 1 of 4 C' ca :JO <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020 <br /> C ri n <br /> v , uuu(� <br />