Laserfiche WebLink
I. <br /> LAND USE PERMIT APPLICATION —Burnett County, WI L b <br /> Applicant Complete All Sections Below This Line 5� o <br /> permit Types and Fees:(Please,check appropriate boxes) CD t <br /> Dwelling/Principal Structure $300 c Addition/Alteration to Dwelling/Principal Structure co)�SZDd N <br /> CO ti <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 G <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 N'..„._O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 4 <br /> XBunkDeck/Stairs/Patio/Retaining Wall/Sidewalk <br /> house $250 g "IDriveways/&Campground Structures $1 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 t <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 <br /> C <br /> *NOTE:After-the-fact permits(permit squired 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. ,5 11.. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 7 • <br /> Property Owner's Name �'�"�_---� �-�D' h dmf? 41,hei• . g o lb <br /> 1 )Q��� 11 <br /> Property Owner's Mailing Address: l0 Cit in./ L4 , 5F/co 4 c 1`-11 5 c/b v/ $ , <br /> City State Zip <br /> Property Site Address:��IO 4.nIL- Ifs <br /> fir / (.../ l f <br /> Contact's Telephone Number: <br /> 715-- .�j_ 2 cam'( < ',,-7,` n o '' <br /> a. <br /> Contact's Email: 1/94 I.�CA(A l 'e. 63gh,S yc a i/,G C•'� o <br /> co <br /> Legal Description of Property: /" y AA.-el c. djoYZ 3 <br /> `` , ) o a <br /> Section#:1 6 Town#:<3 41/V N Range#: I Li W Town of: e,.(5 4 . v <br /> 5. <br /> CM <br /> *Attach additional page i needed for lengthy description OR attach a copyofthe deed OR attach tax system property <br /> P8 f SY P ! Y f� p Y q <br /> Di <br /> Tax ID#(1-5 digit number;found on tax statement): / D 3_8 / rr <br /> Proposed Use of Structur Addit'o • -T�D 17€4 rd 15 4(G Dl[.L a[i-h/C N''- `, <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck:etc.) X <br /> Building Contractor: Sewer Installer: M i <br /> H <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **Tl,e applicant needs to contact their UDC Inspector to determine if a permit is needed froin them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured z <br /> home additions,and bunkhouses.** <br /> H Fee Rec: A40O <br /> 74 Check#: a,isl' • <br /> e <br /> Date of staff site visit:,^5 Initial f site visit staff: IAA !,____ n-1 <br /> w- 1 <br /> 4(1, <br /> APPROVED BY LAND SERVICES OFFICIAL DATE:/O -7 � r' : 1 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF —+ 1 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT "' <br /> m' a ha <br /> Transcendent: - Page 1 of 4 r <br /> Burnett County, WI Land Use Application—Rev 6/2020 3 __ <br /> Laserfische: - <br /> t <br /> b <br />