Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett Count WI or <br /> , `° 1= <br /> � N <br /> Applicant Complete All Sections Below This Line vi <br /> Permit Types and FeesiPlease,check appropriate boxes) <br /> w <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 F� <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 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °, <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 \ <br /> Filling/Grading $150 lBoathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 _ <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three tunes the normal fee. <br /> b <br /> *Communication Towers,Camping Permits&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. <br /> Property Owner's Name: Gtw Kj S Pn o W N <br /> n <br /> c7 -r <br /> Property Owner's Mailing Address: /)- N_ .Y w D u Gu rH r"fVCD <br /> s—sP w �� <br /> City State Zip ' <br /> Property Site Address: e, o l _ /�r, u-, ,Leto e LC:e_bs�*- SL(r C/3 _ 0 <_ <br /> Contact's Telephone Number:___-2AK_'�13 -0 y I ° g <br /> -b t d <br /> Contact's Email: rClwc1 how( �� �� yvux, (. t'd/V1 im <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address: @,BurnettCountyW1.gov °O W <br /> 3Sm t/►`I r°�28 t► ,2�cyt7 tulr",mi �;l�ya <br /> o ;tyt� � Q N N <br /> Legal Description of Property: <br /> Section#: e lo_._.Town#: -V 3 9_._N Range#: _P. I - -W Town of. fn_e-c•'t vn _---__---- _-- I '� <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):- Jlj`1(o !� N. <br /> Proposed Use of Structure/Addition: P&--k 0 -� <br /> Anticipated Start Date: r..- I ---:k5 (tlome/Cabin;Commercial Business;Bedroom;L)eck;etr..) <br /> � Gu Zj <br /> Building Contractor: A t-u L CCns 7fu C i t a n/ Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLYNO <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Z <br /> OI 1M1:eT ALL. SETBACKS 6' <br /> n <br /> ZO FOLLOW .4T-T-AC-FIer,-�, F71000PI.A/N AGBCZKuEA/T <br /> Q SEPTIC iAA1Wt uoS 'M 8C SECu.&- By L-DU4 a CttRi/U By Fee Rec: /25 <br /> °z Check#: ] - <br /> r <br /> 0 <br /> Date of staff site visit: 6I24125 Initials of site visit staff: S � I 3 M <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 61612025 .�� <br /> UPON APPROVAL: APPLIC KT MUST POST COPY OF h <br /> v <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page I of 5 ,. <br /> Burnett County,WI Land Use Application—Rev 11/2024 U <br />