Laserfiche WebLink
LAND USE PERMIT APPLICATION-Burnett County, WI b <br /> Applicant Complete All Sections Below This Line o c CD o <br /> C.- <br /> ',..,7. <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 " VJ <br /> ,ommercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \F <br /> E <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 Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r- \� <br /> Filling/Grading $150 Boathouse $500 <br /> 0 <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. 0 3 r, <br /> z <br /> Property Owner's Name: if't . 4- DN w n-t.- 4 T . wQ1 f- I T p <br /> Property Owner's Mailing Address:21 Not t► �j UY\t<tt^j< , Lek,x- itie.i16 ifl kir <br /> 1 City State Zipk t ,E. r; <br /> Property Site Address: i171Nm..*.- A S GL 4Qt)t....- f W res'5 i <br /> 1 <br /> Contact's Telephone Number: G Si "" ckt4 .-- '= . `I 4 CO c <br /> Contact's Email: 1..Q G • GJ ► iG ra t o 6 iria i L . e 1' <br /> Legal Description of Property: Cot*!'t c 4 k, u,A t` t 5r 1 ` N -0 <br /> Section#: Town#: N Range#: W Town of: b� Iv LA,Vvk m <br /> d <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> 1, <br /> Tax ID#(1-5 digit number;found on tax statement): ' 4 I O , <br /> Proposed Use of Structure/Addition: _ =r .R t C £ x <br /> Anticipated Start Date:., -,, t (Home abf;Commercial Business;Bedroom:Deck;etc) o p <br /> ma.� <br /> Building Contractor: 5't C 4- Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY r` <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: G <br /> z <br /> z <br /> 5 <br /> Fee Rec:\]\\Z---.. ls�� <br /> ilLI\ <br /> g-°19.° <br /> ^ �� y Check#: ��3 3 <br /> Date of staff site visit: Initial;f site visit staff: �. W_ _�___ <br /> IQ o a._�}W <br /> APPROVED BY LAND SERVICES OFFICIA • DATE:S 6 tkW-0 <br /> buil <br /> UPON APPROVAL: APPLICANT MUST POST COPY OFA ` <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT urlruf <br /> Transcendent: Page 1 of 4 3.M c � ! <br /> Laserfische: - Burnett County, WI Land Use Application—Rev 1/2020g3r <br /> _3 <br /> z <br />