Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5• ct� <br /> Permit Types and Fees:(Please,check appropriate boxes) e h o (f <br /> Dwelling/Principal Structure $300 X Addition/Alteration to Dwelling/Principal Structure $200P4 W2. <br /> CS, <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 � LAccessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <. 6) r--- <br /> Driveways/&Campground Structures $125_ WI State Statute 59.692(1v)Structures $350 tc7 0 <br /> Filling/Grading $150 Boathouse $500 v) <br /> w <br /> Permit Extension(1 Year Extension-Allowed Once) $100 <br /> q [k <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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o N <br /> vJ <br /> Property Owner's Name: J�I I 1 1-�55et ro 6' <br /> n <br /> Property Owner's Mailing Address: 84 a [ ra (t r. �'or, lig)t 5 0( � ' c' <br /> 11 City State Zip o <br /> Property Site Address: $by axi_.44, OY�G. O a d <br /> 4.24061,-v Lt( 54Rit3Fs <br /> Contact's Telephone Number: 4).5l - ,).'1`} - 4705 - <br /> Contact's Email:J i f f s .,1r64- % Q 60+lY\a..iI . L 1 oN Po <br /> oz <br /> Legal Description of Property: 'PC C c V Let 5 (l 6 b ' 51,0 ems' <br /> l• t7 Q <br /> Section#: 5 3.5 Town#:'f 4 O N Range#: R 15 W Town of: J O_C.- _u -. i. / <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ogjED c4 <br /> rt -ce_6 -cu., cam' .� <br /> Tax ID#(1-5 digit number; found on tax statement): to b 4 y <br /> 4,._..+,, <br /> da o <br /> d <br /> Proposed Use of Structure/Addition: (A tC ty rb o nn- ac tttrr (4- 6 rl o (t.JA L # C. <br /> L.- <br /> Anticipated Start Date: Sladll��-/ aO'I-,•- Home/Cahin;Commercial Business;Bedroom;De`.-4; <br /> etc.)f'roM Cr 0.w <br /> Building Contractor: ' V.4-?...1.-1 \ Sewer Installer: 5 e 4.4 i. 5..-r-N-- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY —� <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z D <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 <br /> home additions,a d bunk ous s.** <br /> C (( 5e-it LI s e( 5AV 31 L� , '22 <br /> - <br /> Sot!: s�td427 bG rCf, Ve Or C'p4iitae v .01,. ,/- <br /> II <br /> 1, S'�C/h. i + Fee Rec: <br /> CC✓n le4C l 1311/330 -714S/ m'-eS VdI� Check#:/d0('�5� <br /> r� �aD� Atiutr{- beu <br /> d <br /> Date of staff site visit: WO?' Initials o site visi.t. / > <br /> APPROVED BY LAND SERVICES OFFICIAL: I #7 DATE: f l 1/ P ,.. ( <br /> � � C <br /> UPON APPROVAL: APPLICANT>MUST POST COPY OF n <br /> vc�a n <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT Z2 <br /> r N <br /> Page 1 of 5 5 FR <br /> Burnett County, WI Land Use Application—Rev 12/2021 < � JJ <br /> to <br /> En <br /> -.3 <br /> a <br />