Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI a `° <br /> Applicant Complete All Sections Below This Line ; g. o <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 d <br /> N <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> "Q Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 G <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 C� _W <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ee <br /> Filling/Grading $150 Boathouse $500 : <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 <br /> z <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. r <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. W <br /> Property Owner's Name: \--\c\NAJ( l , \l—( tIP •operty Owner's Mailing Address: wet 01-4 C4 V\\ WOzge_1 �1,i ? i , <br /> State b <br /> City Zip a <br /> Property Site Address:9o(?oq C4 146„ \---\ y s4 StateE. <br /> W _. D <br /> Contact's Telephone Number: —1 1 --/411.0-015c,1--So c <br /> 1 -7 n. <br /> Contact's Email: lU C,X-�cNnapa� l p(r.QtA.I.CNS e <br /> Legal Description of Property: I V W \l 'J`k ``t <br /> /, 0 00 <br /> Section#: Li Town#: ' 9 N Range#: / `1i W Town of: Q j (. 5. <br /> go <br /> *Attach additionalpage i needed or lengthy descri tion OR attach a copyofthe deed OR attach taxsystem roe page.* <br /> * <br /> .I� .f S Y p property r'tYP 8 F <br /> 5. <br /> (121/(PTax ID#(1-5 digit number;found on tax statement): 1 (121/(P <br /> Proposed Use of Structure/Addition: Qct C\,( \ A,( v) <br /> .-3 H <br /> Anticipated Start Date: �SPrQ (Home/Cabiin�Commercial Business;Bedroom;Deck;etc.) I <br /> Building Contractor: c).(-e�Mie►c Sewer Installer:(',N434M <br /> -3 r <br /> AREA 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 for any dwellings, dwelling additions,manufactured homes,manufactured <br /> home additions, and bunkhouses.** M <br /> >) j© (1) Cta P CfriJ ( 'CIN5 <br /> Pucc3„A- 5- d A, Prone_ eryx P d3--db <br /> as 3eo-o oe <br /> -t" C ut k�S Se�t�c P�r�ecQ `ficcn�6 r1 u) Fee Rec: 15U <br /> f 6 Check#: i471 <br /> Date of staff site visit:/0"-(9-4V—(9°;0 Initi s of site visit staff: PY-- <br /> CD <br /> APPROVED BY LAND SERVICES OFFICIAL: istr •--- _ DATEI/O---))3--cped-0a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 4 iR 5 fi <br /> N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o 2 <br /> 04 -0 a, o <br /> Transcendent: - Page 1 of 4t."�Lo 1 <br /> Laserfische: <br /> Burnett County,WI Land Use Application—Rev 6/2020 t1 R. . �! <br />