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LAIN USE PE i" '� 'I T APPLICATION - Burnett County., WI r <br /> Applicant Complete All Sections Below This Line ' c tE EA � <br /> Permit Types and Fees:(Please,check appropriate boxes) \ ° <br /> n v <br /> Dwelling/Principal Structure $300 r Addition/Alteration to Dwelling/Principal Structure $200 ` <br /> Commercial/Industrial Structure $300 !!ll Addition/Alteration to Commercial/Industrial Structure $200 \ <br /> Accessory Structure(Garage,Shed,etc.) , $150 Addition/Alteration to Accessory Structure $150 I' 6- o <br /> a <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 'N. <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0-:.r-' <br /> Filling/Grading $150 Boathouse $500 <br /> w <br /> Solar Panels (Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 ?. <br /> i <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. v <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. z ` <br /> P <br /> *Ti MO <br /> rt 6 <br /> Property Owner's Name: C.-<''' A., S 1 1 a <br /> Property Owner's Mailing Address: e 8 29 $77f a I QI Pe,/o fW 1-)2 s1'2 Sie,2-22 1 n <br /> City State Zip <br /> Property Site Address: l" t " o c <br /> . ! <br /> Contact's Telephone Number: ---\ d <br /> CD <br /> Contact's Email: <br /> D '71. <br /> o <br /> Legal Description of Property: IC. / Cj v t/ T/ C� s oo <br /> l� <br /> Section#: 2-7)2-7) Town#: 0 N Range#: /cp W Town of: (er/(c vN <br /> 3. <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): 13 7522 o <br /> Proposed Use of Structure/Addition: ) 11: 5 <br /> Anticipated Start Date: / (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ' •3 <br /> Building Contractor: � 8, k-5 LtcC►^-> Sewer Installer: • <br /> " W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY O v <br /> THIS PERMIT IS SIJ i,.IECT TO ALL CONDITIONS LISTED BELOW: z R <br /> **The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to L <br /> ANY construction taking place for any dwellings, dwelling additions, manufactured homes,manufactured <br /> home additions, and bunkhouses.** li\ 11 <br /> / <br /> 6 15 er'w►iY " iS lcr rtp/ac�lfu/ , t5.$44 e- of ` ,re.-vN4�i74oa( <br /> OH `i11 5 nom-6.47`t 'RDr'tM1'VI, , GA o Fee Rec: p' <br /> Check#: // <br /> /Z�/� ZZ 7.. <br /> o <br /> Date of staff site visit: S Initials of site visit staff: �/, m <br /> APPROVED BY LAND SERVICES OFFICIAL: ,,,QDATE: 7 1/�Z� cc <br /> UPON APPROVAL: APPLICANT MUST POST C *TY OF <br /> m , Iiiiii <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT .. o <br /> C N <br /> r <br /> • N <br /> Page 1 of 5 <br /> :uirnett County, WI Land Use Application-Rev 05/2022 :i. <br /> 0 Lc J <br /> a <br /> o <br />