Laserfiche WebLink
„ - LAND USE PERMIT APPLICATION — Burnett County, WI cr <br /> a <br /> _ Applicant Complete All Sections Below This Line o N <br /> ermit Types and Fees:(Please,check appropriate boxes) a <br /> 1,-Dwelling/Principal <br /> miDwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <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 ..D c <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 a <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 -p <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° p <br /> Filling/Grading $150 Boathouse $500 r, <br /> Per Year) Once) $100 <br /> I <br /> ° j.T <br /> p g Unit(One $100 Permit Extension(1 Year Extension Allowed c\Tf, ' <br /> Six Month Camping <br /> NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. 0 <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. 1,..1\” <br /> D(( ' J o ` <br /> operty Owner's Name: l� `l KO t t b�1 <br /> i <br /> / 7 S��e� Irl e`er. 1411 S1{ 9 3 <br /> operty Owner's Mailing Address: �P�G+� b M• <br /> n ' /,4, City State Zip b 1 <br /> operty Site Address: G Co_ /'a C . <br /> c) <br /> )ntact's Telephone Number: (ofoo- $(6- 7'1 7 9 °-.< <br /> N <br /> )ntact's Email: °' <br /> Pk'�.((aja�t( sefvtcei nom, nef � o <br /> ;gal Description of Property: P IV ( Fe � t e 5'ti carte IUW SCJ of , <br /> ction#: z.2., Town#: "!a N N Range#: 16 w W Town of: 0 ale I07 <br /> "ttach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o <br /> ix ID#(1-5 digit number; found on tax statement): n <br /> oposed Use of Structure/Addition: nit e, <br /> �tici ated Start Date: p H <br /> h 7 /512.0 (Home/Cabin;Commercial Business;Bedroom;Deck:etc.) ? c <br /> zilding Contractor:Q p j ems- :4174%-71A: 7 /6 <br /> � v/ffi l�..5`7actioA Sewer Installer: Nxi!►�1. .,•,� r <br /> REA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **The applicant needs to contact their UDC Inspector to determine if`a permit is needed from them prior to <br /> ANY construction taking place Jroany dwellings, dwelling additions, manufactured homes, manufactured Z <br /> home additions, and bunkhouses.** z <br /> LX 15I 01 AOLASc�• � - 1c - ved ane .1r r-6 <br /> !"- <br /> Welkin rT w\ �SS L4 d` � <br /> Fee Rec:$459 <br /> 6 Check#:� <br /> l3--- 2� <br /> A\C- --.e u ' <br /> ite of staff site visit: teals of site visit staff: —..�J <br /> 1 ›. 5:5:iii <br /> PPROVED BY LAND SERVICES OFFICIAL: V ____ <br /> DATE: q-ii-ooDo I c <br /> TPON APPROVAL: APPLICANT MUST POST COPY OF 12, - M <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT Q <br /> Transcendent: - Page 1 of u.i. <br /> aserfische: Burnett County, WI Land Use Application — Rev 6/2020 LL J,' <br />