Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County, WI t 5 <br /> s. b <br /> Applicant Complete All Sections Below This Line 5' <br /> co I <br /> Permit Types and Fees:(Please,check appropriate boxes) ° ;h <br /> ;\ G _1 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 \W <br /> 0 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 w <br /> x Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 \ i' <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ,, <br /> Deck/Stairs/Patio/Retaining Watt/Sidewalk Bunkhouse $250 <br /> C1 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 '• <br /> Filling/Grading $150 Boathouse $500, Ga <br /> Six Month Camping Unit(One Per Year) $100_ Permit Extension(1 Year Extension-Allowed Once) $100 <br /> v� <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. F <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. 1 '‘ <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ' b <br /> C t- <br /> Property Owner's Name: G\Na-- r.r e ''cQc %CVC\ \x. z <br /> 0 <br /> .71 <br /> Property Owner's Mailing,Ad s: 70 V3-. d 0\L k,..Am c. \-,V..)/ \,}9� f LTk �C� a t <br /> /O City State Zip <br /> Property Site Address: ZIo.�lwotiA. `j.\i & V t �pr- VA= ,i"L%'V 5' (-) ri <br /> J • <br /> Contact's Telephone Number: 1\S ^ 1'231-N- 0%25E c �,, <br /> Fp <br /> Contact's Email: e..,\lruct�o�,r\ Q,NiCn�cj•C V\ a • <br /> CD k <br /> Legal Description of Property:) 2-071- /pork mood PC2iA - .. <br /> N '0 <br /> Section#: aS Town#: 3 9 N Range#: 16 W Town of: I-lee/10n 5. 00 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* d <br /> / 5 <br /> Tax ID#(1-5 digit number;found on tax statement): #04/'-'7',' - Z77[Q . <br /> Proposed Use of Structure/Addition: (' ��a✓cy� `n <br /> � <br /> Anticipated Start Date: '3',,..4e /5 ZGZ/ ✓(Home/Cabin;Commercial Business;Bedroom;Deck;etc.) c <br /> Building Contractor: /1/01/ c.,,0/ at.,Io1..r c Inc. Sewer Installer: <br /> i -I <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY \ _ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: w !;r :. 4 <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.** w <br /> x' <br /> © ,v07' 74 h USel - e. `tur..Igh Aa4/6,4,4 , <br /> I. Make, Sure, Yv M to 4/1 S`''� 6 a sr (� <br /> tb <br /> xFee Rec. <br /> Check#.:-1/!)---=1/9 <br /> Date of staff site visit: 33 Z 2 Z� Initials of site visit staff: i!/' 1 r t <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: Wo 2,/ <br /> w <br /> • aETA <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF ; <co co <br /> ITE <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <br /> ' oTranscendent: - Page 1 of 4 :. 0, <br /> Laserfische: - Burnett County, WI Land Use Application-Rev 12/2020 %;,• s <br /> L J1 <br /> b <br />