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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 5 r. <br /> o ' <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> 4,,,,, p <br /> Dwelling/Principal Structure $300 v Addition/Alteration to Dwelling/Principal Structure $200 d <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 <--- c, <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ^ ._ op <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° 6 <br /> Filling/Grading $150 Boathouse $500 rkii <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 r` r <br /> cr I <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. = <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. e 0 <br /> r <br /> Property Owner's Name: Adam Johnston ° z p <br /> 0 <br /> Property Owner's Mailing Address: 12125 N Gabrielson Lake Rd Luck WI 54853 g <br /> City State Zip <br /> Property Site Address: 12125 N Gabrielson Lake Rd n <br /> Contact's Telephone Number: (612) 730-7960 Z N <br /> a ohnston baliusmarketin com a <br /> Contact's Email: 1 @ 9 -e <br /> cD <br /> Legal Descri tionti/ of Property: SW NW EX W 7 RDS 5' OF S 22 RDS <br /> Section#: s% Town#: 37 N Range#: l$ W Town of: Trade LakeoGm <br /> o <br /> "*Attach additional page if needed for lengthy description OR attach a copy ofthe deed OR attach tax system property page.* <br /> p <br /> Tax ID#(1-5 digit number; found on tax statement): 24249 <br /> Proposed Use of Structure/Addition: Roof mounted solar system (11 panels, 1 inverter) - 3.52 kW-DC <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom,Deck, etc.) o mi x <br /> Building Contractor: Solcius LLC Sewer Installer: I _i 5 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> **The applicant needs to contact their UDC Inspector to determine if'a permit is needed front them prior to <br /> ANY construction taking place for any dwellings.dwelling additions, manufactured homes,manufactured z <br /> home additions, and bunkhouses.** <br /> z Fee Rec: .ZDO`_JD <br /> K.K. Check#:jaaalid <br /> �nI o <br /> Q 2l/ <br /> Date of staff site visit: 3 J 24 Initials of site visit staff: i J!-t a ; <br /> Z' <br /> r--. <br /> o ��`Jr <br /> H APPROVED BY LAND SERVICES OFFICIAL: DATE: 0 Zr''' L.i <br /> I < <br /> . Uu <br /> UPON APPROVAL: APPL ANT MUST POST COPY OF a x <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ° m g �° <br /> Transcendent: - Page 1 of 4 n 1 N <br /> Laserfische: - Burnett County, WI Land Use Application —Rev 12/2020 < » <br /> 0 <br /> a <br />