Laserfiche WebLink
LAND USE PERMIT APPLICATION - Burnett County, WI a I b <br /> Applicant Complete All Sections Below This Line 0 w <br /> a <br /> Permit Types and Fees(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 " O <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 .J O <br /> 1 Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 `. <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 W <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 1 OS <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. `D <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ' <br /> z <br /> Property Owner's Name: !11 Lv. I cY 1 I ,.. o o <br /> o. <br /> Property Owner's Mailing Address: 3? ( Li, p‘ ,1_0 e a/nLn, L S966 In ft r <br /> % jj ((� /� City State Zip ° E <br /> Property Site Address: ,3 9'5 l,), .p*'e•- L k,e �c�. o "A <br /> N <br /> Contact's Telephone Number: ?6 3 - 71f Z - `(qi O& a TT <br /> d <br /> c+ � <br /> Contact's Email: 5�capi,Aer SC,: tt5 vCat,cG . 4f? `°D <br /> **If staff has a question about this applicatiovl,you will be contacted via email. Make sure your email address is N ro <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and °Q <br /> o <br /> @BumettCountyWl.gov m <br /> Legal Description of Property: C.& l.''0J ko-t -,?4 3 /C / ! 3. <br /> Section#: /2 Town#: qi N Range#: / W Town of: 5- <br /> G1j i S S u, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* i <br /> Tax ID#(1-5 digit number; found on tax statement): '- 1,2 2 L _ <br /> —3 .3 <br /> Proposed Use of Structure/Ad itio r . g):4t q C? '— <br /> Anticipated Start Date: 5 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) W <br /> Building Contractor: i1 e Sewer Installer: z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Po <br /> THISS PERMIT IS SUB.IECT TO ALL CONDITIONS LISTED BELOW: <br /> I <br /> P)NO'i- -6( h vi/nan ,�kabi/Whv 1 <br /> Fee Rec: 15D"-- <br /> o <br /> Check#: l 71 <br /> ni <br /> ° ) fL } _ <br /> Date of staff site visit: 7 //3f 023 Initial of site vi 't staff: k/ rn< o. lifii <br /> APPROVED BY LAND SERVICES OFFICIAL: • ,r DATE: V 7/a1-: < 5 r <br /> y @ 'm <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT . r <br /> M <br /> Page 1 of 5 L LL <br /> Burnett County, WI Land Use Application—Rev 3/2023 rn <br />