Laserfiche WebLink
I <br />LAND USE PERMIT APPLICATION - Burnett County, WI <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Please, check appropriate boxes) <br />tion/Alteration to Dwelling/Principal Structure <br />Dwelling/Principal Structure $300rAddition/Alte <br />$200 <br />Commercial/Industrial Structure $300ration to Commercial/Industrial Structure <br />$200 <br />Accessory Structure (Garage, Shed, etc.) $150tion/Alteration to Accessory Structure <br />$150Accessory <br />Structure (Commercial/Industrial) $200ion/Alteration to Bunkhouse <br />$150 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk house <br />$250 <br />Driveways/& Campground Structures $125ate Statute 59.692(ly) Structures <br />$350 <br />Filling/Grading $150 1 Boathouse <br />$500 <br />Six Month Camping Unit (One Per Year) $100 1 jPermit Extension (1 Year Extension - Allowed Once) <br />$100 <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. <br />Property Owner's Name:1KnwVN y e, <br />Property Owner's Mailing Address: �—, w 4e� co i x I 1 f OryQV e Wz t/ e30 <br />City State Zip <br />Property Site Address: 5C-% "N 4-+ <br />Contact's Telephone Number: (793-93q-17,72— <br />793-9.39-127ZContact's <br />Contact'sEmail: <br />Legal Description of Property: 5 /�% �,l £ �j t,) <br />Section #: Town #: `"� I N Range #:BZW Town of:�,,, ; t{ <br />*Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system propertypage. <br />Tax ID # (1-5 digit number; found on tax <br />istatement): <br />Proposed Use of Stnichue/Addition: D- k'( 0" q C 5A0 { 2 o -q- 6 VV L vj <br />1 <br />Anticipated Start Date:_ In. g `-' 15e4-, (Home/Cabin; C mmercial Business; Bedroom; Deck; etc.) <br />Building Contractor: tcvti� `tiw 1 h y�S Sewer Installer: <br />AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />0/4PPROVED <br />Date of staff site visit: J 7 — J&` Initials of site visit staff: <br />PERMIT APPROVED BY LAND SERVICES OFFICIAL: DATE: <br />UPON APPROVAL: APPLICANT MUST POST COPY OF <br />SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br />Page 1 of 4 <br />Burnett County, WI Land Use Application — Rev 3/2018 <br />N <br />(D <br />:� I I <br />x Fee Rec:pw-k <br />-+/so- <br />m <br />