Laserfiche WebLink
LAND USE PERMIT APPLICATION— Burnett County, WI 3 <br /> Applicant Complete All Sections Below This Line == o <br /> Permit Types and Fees:(Please,check appropriate boxes) ° <br /> _ <br /> Dwelling/Principal Structure $300 )C Addition/Alteration to Dwelling/Principal Structure $200 d 0 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> pc) <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 O <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 o <br /> Filling/Grading $150 Boathouse $500 = X) G <br /> o . <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 v <br /> f <br /> fw 116 <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 /> Property Owner's Name: v en U 5 I 'M 4 . re e►l i , i <br /> o <br /> 1 des? E y / � �,// %4 = <br /> Property Owner's Mailing Address: G Lai Q Cr^ V1l•�S <br /> c <br /> ca <br /> 1 �`5•y /L � � ity State Zip <br /> Property Site Address: ` (, <br /> Contact's Telephone Number: "7/5- 6 25 -0 33 I o <br /> 0 CD <br /> Contact's Email: rn tly Lt.) +-er L{, Gt i']co , C O ni e <br /> Legal Description of Property: <br /> CSM v I / CSN C)01/Z-,01". -i2) <br /> Section#: Town#: N Range#: W Town of: R J $ = 00 <br /> 5' <br /> o*Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system propertypage.* <br /> P <br /> Tax ID#(1-5 digit number; found on tax statement): iS. y 0E. <br /> f5/504: <br /> Proposed Use of Structure/Addition: s C(" ► �C)f :. 6 4-eC. a' <br /> C <br /> Anticipated Start Date: q —3-- 0 (Home/Cabin;Commercial Business;Be. Dom;Deck;etc.) E k <br /> �,c) (i e �.zs-f.. <br /> Building Contractor: Sewer Installer: <br /> -3 <br /> AREA BELOW THIS L E FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> k <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> A.VYconstruction taking place for any dwellings, dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** Po <br /> Fee Rec: t1� <br /> Check#: 23-3/ <br /> i ^~ <br /> Mil-- <br /> rtlDate of staff site visit:c�` D0�� Initials f site visit staff: Z .__, r �'' _ <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: F�) c;� < ,� <br /> ml�' tJ u� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF ?W cz Cj <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z <br /> r.ao <br /> Transcendent: - Page 1 of 4 n N.) <br /> c 'C <br /> Laserfische: Burnett County, WI Land Use Application- Rev 6/2020 n � <br /> 0 <br /> a `-_� <br />