|
' LAND USE PERMIT APPLICATION - Burnett County, WI r
<br /> a.
<br /> 14
<br /> Applicant Complete All Sections Below This Line 5' c
<br /> Permit Types and Fees:(Please,check appropriate boxes) a.
<br /> p �
<br /> Dwelling/Principal Structure $300 xAddition/Alteration to Dwelling/Principal Structure $200 d 7�.�
<br /> CD
<br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 "3\).
<br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150
<br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0
<br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250
<br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 r
<br /> Filling/Grading $150 Boathouse $500
<br /> r
<br /> ,9
<br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 111.
<br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. w
<br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees.
<br /> *Items not listed above will be treated as accessory
<br /> (structures,such as:pergolas,landscaping,etc. ro
<br /> Property Owner's Name: 4li 11�Ci,11'(, A, Jc red ICA z 10
<br /> CL�Q,� o
<br /> Property Owner's Mailing Address: Q7L/640 &cii G U%cid LG/jC 4 0„, lig J `/(Jf o
<br /> ity State Z�ip -o
<br /> Property Site Address: , . s !' i ' 0• e _ Yr r 5• t
<br /> 4
<br /> Contact's Telephone Number: 7/5- 2)0- 1 rsg o• T,
<br /> CD
<br /> Contact's Email: lei rl5(J rod'1 crt el Mai I, C'OIYI d
<br /> 0.
<br /> ~�
<br /> JJ�� E.
<br /> Legal Description of Property: Zoe-e- 2- c...5/47 V, 242 #, /7o
<br /> IS' N b
<br /> Section#: 3 Town#: 3 O N Range#: /V W Town of: wet_t ° °°
<br /> op
<br /> *Attach additional page if needed for lengthy description OR attach a copyof the deed OR attach tax system property page.*
<br /> 0.
<br /> Tax ID#(1-5 digit number;found on tax statement): Z //8
<br /> Proposed Use of Structu e/ dditi n: Agie , Qo a c” "'
<br /> Anticipated Start Date://i 1° P (U(fu Qoa l (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) o
<br /> J = d
<br /> Building Contractor:getff/p O/.,Sd/1 Sewer Installer: Wade, A)Sin ) H
<br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY
<br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: •O
<br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to
<br /> ANY construction taking place_for any dwellings,dwelling additions,manufactured homes, matutfactured z OQ
<br /> home additions, and bunkhouses.**
<br /> ,'s f w tA4►'f' /'S 40 1eol4cde- 7%c roof s yt> ,, on 1z'e.
<br /> 51r'uc71,e_ 1,42,Y4 ctc SS Z`f.iGO Eerie pion eke4
<br /> �� fV o e.kI4 AS 1 t;IAD"F >Li1 Q, f07 / 7 ,7L ,5 bliO C',
<br /> al'oo,,..,,,,// Fee Rec:
<br /> `-""r 4' Check#: y iv
<br /> it
<br /> Date of staff site visit: 1/Z I 2.0Z./ Initials of site visit staff:/ ......... / Z-1 ... __
<br /> I
<br /> APPROVED BY LAND SERVICES OFFICIAL: Ammo,
<br /> DATE: 2-1/6/30 Z �
<br /> UPON APPROVAL: APP ICANT MUST POST COPY OF m.'„,' = I
<br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT '0 4 `J'
<br /> t=
<br /> �, Gc
<br /> i7 �, C
<br /> Transcendent: - Page 1 of 4 '` ^:
<br /> Burnett County, WI Land Use Application—Rev 12/2020 < g '
<br /> Laserfische: -
<br /> I
<br />
|