Laserfiche WebLink
LAND USE PERMIT APPLICATION— Burnett County, WI a b <br /> - Applicant Complete All Sections Below This Line 6' c <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> X Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> C7 <br /> I,'Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ",_ `Sy <br /> \ <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> I <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> C <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 � 0 <br /> Filling/Grading $150 Boathouse $500S ,) <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 ik <br /> cn <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. = <br /> D. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. r <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. .1:v P' <br /> 0 <br /> Property Owner's Name: 17..44 le( telth,/a 's,4-6 gy Ail X, J yie /ft/A)'5ch o .. <br /> Property Owner's Mailing Address: 23 /3' ele4 .p/u Ave A-! 52.44),/,A- Aix `i �,?_I' o , <br /> City State Zip -0 • <br /> Property Site Address: 5004/ (c �� �oe j' ,< L ...1 <br /> Contact's Telephone Number:‘.51--. 6) 7 - `f," 15 (Do n) o c <br /> • <br /> Contact's Email: pA� ,. r✓�vretz/a L t/�//D0 . e�cI-1 I <br /> t; v <br /> Legal Description of Property: 1.o 11. ! C S'.4 2 O5S V I! ?)/ `- 1' <br /> N cC <br /> Section#: '3 Town#: VO N Range#: /7 W Town of: q-t1 J'',3DB' <<'f _2 °Q `� <br /> *Attach additional page i needed or lengthy description OR attach a copyofthe deed OR attach tax system property page.** 00 ri� <br /> P S .f f g Y P c/ Y P P tYP 8 � N <br /> Tax ID#(1-5 digit number; found on tax statement): ) 7 9 FO k) ' - <br /> t`Coal e 4 <br /> Proposed Use of Structure/Addition: / <br /> Anticipated Start Date:t7M7 3/ .,'?',) ( (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: g4,55- -/a/4-,thie, . y <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 z <br /> home additions,and bunkhouses.** <br /> (Dft( Fcck , <br /> 5Wei- �r emerc Veh,ck <br /> r; e /amw' Aireecchtde t ec.U5-iii b 89I-- <br /> d <br /> Fee Rec: <br /> 4' Check#: ) 00 Li <br /> Date of staff site visit: b-71 Initi.Is d site vis't staff: a <br /> 'jam � � <br /> II �' /� DATE: ���(J/� -_- `. 1 <br /> APPROVED BY LAND SERVICES OFFICIAL: 1 <br /> � [� <br /> UPON APPROVAL: APPLICAN' UST POST COPY OF Co <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT a, - I <br /> PP <br /> Transcendent: - Page 1 of 4 o <br /> Laserfische: - <br /> Burnett County, WI Land UseApplication—Rev 12/2020 g: <br /> s I l <br />