Laserfiche WebLink
LAND USE PERMIT APPLICATION - CAMPING— Burnett County, WI a 9 <br /> A licant Co lete All Sections Below This Line N <br /> Permit Types and Fees: (Check appropriate box) d <br /> Ca in Unit Six Months Per Year $100 3 Year Camping unit $300 <br /> *NOTE:After-the-fact(when no permit is obtained prior to camping unit placement)is up to three times the normal fee. p <br /> *Sanitary Permit MUST be approved prior to placing camping unit on parcel CN <br /> Property Owner's Name: iI LE3 r r S D h <br /> Property Owner's Mailing Address: 15 7 0 at S // SAO� " <br /> _ nn� ity State Zip <br /> Property Site Address: � 13 <br /> 5 ,/v L h �� d � � '�l W l 4�_3� b <br /> co <br /> �rO 1 1 9 _r <br /> 50-7 3c7 <br /> Contact's Telephone Number: � o� 0` <br /> Contact's Email: Q,w I �fit-,-,t,r� � ►�„ y) e=t a b I� �.D!t, g <br /> **If staff has a questi6n about this application,yoA will be contacted via email. Make sure your email address is 021 b <br /> legible and your email provider will accept emails from the following address: @BumettCountyWI.gov n O <br /> CSP1 <br /> Legal Description of Property: / C) o L 2 3 p 9 q 6-0 3%p y 3 D L, lyW <br /> Section#:_ _Town#:___4�_N Range#: W Town of. <br /> N d <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* W <br /> p c � <br /> Tax ID#(1-5 digit number;found on tax statement): -�D O o - <br /> Sewer Installer: /1 JG _- Yo? A kJ W <br /> - d �p <br /> Camper Type--[-au'P- I. ►^ ;�,L Make: Model: Year: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: A o m <br /> C sys� I''S 4e--Gy- s ew►u'� lit 2nzS, �►�, is peels � � � d <br /> k> loe co>~nP/e,7� aA W ®ram 7� J1fe COUN y 111�1z°ZS, W <br /> ti <br /> UQN�y oKe_ Cc v^p H clllowed L4t>qj ' f—*MA►f'• z N <br /> ►' e"V`w�1�7�" ex rNe.S Dw IZ /II 2D2.5� Caw.Pty' 4 be- VeA4,jeW-W 00 <br /> ,� N, „ � P rb p�6, o� s� �plopW/y . <br /> v <br /> � Fee Rec: �= <br /> Date of staff site visit: 7 _ Initials of site visit staff: Check#: <br /> APPROVED BY LAND SERVICES OFFICIAL: <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> IN PLAIN SIGHT > <br /> SIGNED PERMIT APPLICATION0 CD <br /> Pagel of 3 a`` <br /> Burnett County,WI Land Use Camping Application—Rev 11-202 <br />