Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> .. b <br /> Applicant Complete All Sections Below This Line 5. 1 % <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 '� 54 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r <br /> Filling/Grading $150 Boathouse $500 ._ <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 v' <br /> P <br /> y. <br /> *NOTE:After-the-fact permits(permit aquired 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. ro <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r g lb <br /> i o z t <br /> Property Owner's Name: Z j(yu,1_ -- ..,›C— s- .r, <br /> Property Owner's Mailing Address: (j .��' - —Eine! J�ri v p, S ICX''Vi evil mq r..-;67210 $ i\ <br /> ' City State Zip P• n <br /> cn �v <br /> Property Site Address: 2.2 71�- i-b rr ?o � „�. <br /> Contact's Telephone Number: ( ,5 •I •- 2l,I -.5 4-5 c a <br /> d <br /> Contact's Email: Q/r (jdj��,� i fl�Gt; ,��� 0 <br /> Legal Description of Property: L 25J � <br /> P P rh': � (-�:A���r,i,� ?so 0•7•c?4'L'Z-345;•-18-:�`}-5 is-27tc-o:330� � ao <br /> aol 2 <br /> Section#: 3t7 Town#: 7g N Range#: l W Town of: •�;£,r��r�, r- t:) <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ~. <br /> Tax ID#(1-5 digit number; found on tax statement): Lc-Li;Q aZ <br /> Proposed Use of Structure/Addition: Q' k-c,c, . <br /> Anticipated Start Date: 144.1%/ ,245 2.1 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) Cj <br /> 6 <br /> Building Contractor: Sewer Installer: t "-3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLYL. <.,.6., <br /> THIS PERMIT IS SUBJECT TO ALL CONDIITIONS LISTED BELOW: <br /> Z /Mt a//e4V 14. / <br /> T�vyl s t f v A-Z✓-o8' '`e <br /> o6rveotrt... ,1717A0 6Dt are...gG , V %41.14+'1 Ilei/X14:24 • C)Cl ; <br /> t t <br /> 3 �ec,� it part of M1'fi94liovt, CQK� b oepAQced <br /> r <br /> 0,41-1400-1-- N^; Q' pt^ e f -{10 tit . x Fee Rec: 15(g. <br /> Z yZOZip pia y Check#: 1 Dt go <br /> / tz <br /> Date of staff site visit: �/��l Initials of site visit staff: lilt-- <br /> i � <br /> tzl <br /> APPROVED BY LAND SERVICES OFFICIAL: / DATE: V T a9 / �e r <br /> x <br /> r- <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF y Nm p, <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z d <br /> N� CO <br /> g N = <br /> Transcendent: Page 1 of 4 An.' w <br /> Laserfische: - Burnett County,WI Land Use Application—Rev 1/2020 ro a <br />