Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI <br /> g <br /> <. b <br /> Applicant Complete All Sections Below This Line o' c <br /> Permit Types and Fees:(Please,check appropriate boxes)', a <br /> p <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 O <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 O <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 `. 1 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 P b <br /> G7 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 C' Irk <br /> in Unit(One Per Year o lb Month Camping g ) $100 Permit Extension(1Year Extension-Allowed Once) $100 <br /> CA <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. a <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: G a i G- U. Diow o ,... <br /> z <br /> l�Ie L V o <br /> Property Owner's Mailing Address: 1 sQ qC, IA-c U( j) c 1 a) l/%'le NI Ad, 5soyy r <br /> City State Zip ' <br /> Property Site Address: 4 O/rcni�'It✓t'� <br /> Contact's Telephone Number: 9 5 - x70- 66o �_c. o <br /> c <br /> a <br /> � <br /> Contact's Email: C V••J D�SP Y C1 V_�' ��`PT /I! C d <br /> Legal Description of Property: GL D. Ly/to of peF i live )''5& Ti y)a,i o0 (ti'/ <br /> N b <br /> Section#: 17 Town#: 38 N Range#: 1 7 W Town of: DA/Vise 1 5 L-A-5 x 1 1o/ 8 <br /> 5. °Q <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> Tax ID#(1-5 digit number; found on tax statement):'"'33 1 1 c' <br /> Proposed Use of Structur /Addih2�i 'ItA( 71 br d's9P `n <br /> Anticipated Start Date: Fo H <br /> p � ' i��� I (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> I <br /> Building Contractor: Sewer Installer: <br /> -I <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLYW <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: W <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 Z @ <br /> home additions,and bunkhouses.** // /� A m <br /> 0 Fo(1p& aallGmrtic-I,T i1914 5 q ON74/G► Gc'/ /.i D/V/� <br /> fes'" ,‘/- <br /> 6 Al D / ' g eel/1747 <br /> 7 Fee Rec: (5(� <br /> 0 Alp Mo ,A-6/ 1. :4 Imo'( 1D t /m0���aiAl ♦ 4 Check#:1o.a.3 / <br /> Date of staff site visit: / /3 g I Initials of site visit staff: Pr <br /> 0cA <br /> po <br /> rTI CI, fj <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 00/2V <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF . z C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z, $t- a o 0 <br /> Transcendent: - Page 1 of 4 g 3 `' C <br /> Laserfische: cl <br /> Burnett County, WI Land Use Application —Rev 12/2020 r ? 1i <br /> u <br />