Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5. 6' ts) <br /> Permit Types and Fees:(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 a 'Ir <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 . L.. <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ' CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 c- <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 c ° p �_ <br /> Driveways/&Campground Structures _$125 WI State Statute 59.692(1v)Structures $350 g <br /> Filling/Grading $150 Boathouse $500 v, lll"c'.Qaa <br /> Permit Extension(1 Year Extension-Allowed Once) $100 .. 'U <br /> P <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. g i PA <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o ` <br /> Property Owner's Name: -�� (2.010...Q_C .0 <br /> Property Owner's Mailing Address: C \14:45-4-- 11 MO Rj V i_.cc) <br /> 1011 <br /> ty State Zi o N <br /> Property Site Address:<4C.i'- �1 tt t�✓.?C�7 �1` ( - c <br /> -7 JJ v <br /> Contact's Telephone Number: C �`� L ' `� °' <br /> Contact's Email: il.k b-e-E'�-- 11 a-ICJ-0 t '`'•-• 0+ ill �N o0 <br /> -o <br /> Q <br /> Legal Description of Property: C`'1V2J( 0(1_14-5 (--e 0-4,4A Y "? at (42_ 00 <br /> p" r <br /> Section#: CI Town#: ^40 N Range#: C Cg W Town of: C)_,t4& �. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> c0 <br /> Tax ID#(1-5 digit number;found on tax statement): . a ( 2_ - <br /> Proposed Use of Structure/Addition: MIA—CAL - ' IP ' ' , 0 r • ' <br /> Anticipated Start Date: .,�.v c". f . .. > abin;Commercial Business;Bedroo ;Deck;etc.) \I_ , —3 Ilk <br /> Building Contractor: ��hC°S cs► a 1L . Sewer Installer: vv ` <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z 9 W <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: y <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior tofV <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured J <br /> home additions,and/bunkhouses.** <br /> C 4 07 74, toe uSf / .. pe. Apo/Nam /l, D/ T< dn, <br /> Q Ma kR, sure- 742 M e-€. 1- sae, s e 4c/'- (ii 0 0 7"l) /ie4c), x <br /> N <br /> C4 <br /> / v <br /> Date of staff site visit: 9/i Z/ 20 ZZi /'- Initials of site visit staff: Fee Rec:15d <br /> t a <br /> q v Check#: oU a-� <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: I/J3/?�Z 1 '• ' <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 1 ita <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> W r-..) 511 <br /> Page lof5 xoG o <br /> Burnett County,WI Land Use Application-Rev 12/2021 . iv <br /> J <br />