Laserfiche WebLink
r ' LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> IV <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> Dwelling/Principal Structure _$300 Addition/Alteration to Dwelling/Principal Structure $200 = 'J <br /> ro <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 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 D i9 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° IP <br /> ' <br /> Filling/Grading $150 Boathouse $500 C• (. <br /> 0 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(l Year Extension-Allowed Once) $100 <br /> cr <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. a <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> ix Ir 0. <br /> Property Owner's Name: !\\0%-v i'`— `i C.uu\t.(e—�' ) 1 ,Nfi'v2 ` L;_ o o <br /> Property Owner's Mailing Address: 1 71 I /�/ pip,Vv�tL l 4N1 N) 7 o I, <br /> 'LpCity State Zip a. <br /> Property Site Address: I ci/ 0 5 y b , 1•-r L S e�r‘aLC?1 <br /> Contact's Telephone Number: 7(,' , 1 (p _ ©�� o• c <br /> !::::, O. , <br /> Contact's Email: h, n��4 ..� "� y.,401) (Q,ri" e 0 <br /> Legal Description of Property: 9\ j 9 0 V ^ (J,D 3''')/a. <br /> 0 <br /> oc <br /> Section#: 10 Town#: q b N Range#: iii W Town of: S ' <br /> a <br /> ` <br /> *Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system propertyPa8e.* <br /> P <br /> 7 <br /> Tax ID#(1-5 digit number; found on tax statement): I - 79' <br /> Proposed Use of Structure/Addition: Q.e. b M- (c 1 e'ra`;}�' "' <br /> Anticipated Start Date: 10 - i c—09, (Home/Cabin;Commercial siness;Bedroom;Deck;etc.) 1 o x <br /> Building Contractor: k)k ,L 16,..„, 1 B6 Y:',41Ckewer installer: <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,andr <br /> bunkhouses.** z <br /> e 4. al( 5e-4-bac-its <br /> o4- ( k�►'"w•, k�b �`vsrice bei*.I-- s AA- NIX i M �;o%► . � roc( tk��- �.s <br /> o +�' ,-4i"D1� Gs-' 5 w( tS Rc)' C <br /> Qre <br /> pgwi g fie c#4/ i M eNG06AS SAA AeS W:11 ,le x Fee Rec: i � <br /> `rn�.�„: �� d n o Check#:��ifi.‘ <br /> Lrn <br /> Date of staff site visit: Jd�.0-1 Initials of 'te visit staff: /t z <br /> APPROVED BY LAND SERVICES OFFICIAL: ���// DATE: !Jf cwid-( - m <br /> UPON APPROVAL: APPLICAN UST POST COPY OF . m <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT '0 0 4 fil <br /> Transcendent: Page 1 of 4 .'c~ 1 <br /> Laserfische: Burnett County, WI Land Use Application—Rev 12/2020 <br /> ` ______ ) <br />