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LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line o' c N <br /> = a 1 <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 g 4 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ O <br /> Accessory Structure(Garage,Shed,etc.) $150 kV Addition/Alteration to Accessory Structure $150 Q' 1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 '.., <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> o C <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 br N <br /> Filling/Grading $150 BoathouseN ' <br /> $500 <br /> Solar Panels(Stand alone or roof mounted) _$150 Permit Extension(1 Year Extension-Allowed Once) $100 E. <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. 1 W <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> ,>> o <br /> Property Owner's Name: MACRAE 1- 0 16 UCLA tJ et <br /> a. <br /> fb <br /> Property Owner's Mailing Address: N I )s.LA ON Kb i./ 6 le r i& D 0 . 9-I),3:,. r n <br /> 3? 93 m �t! 1--At( Rn City State Zip <br /> PropertySite Address:- 1� .-1S o N <br /> a. <br /> Contact's Telephone Number: —/IC X19 - n 7 a l C7 <br /> w <br /> Contact's Email: )i-1 u S 1 b ® U t ..SC3 Al — -TEL, 0 c T <br /> Do <br /> Legal Description of Property: 6e.t- / CEA" 1 V T 2e / i 8 <br /> Section#: 7r Town#: 1/0 N Range#: W Town of: cfi f S c`'11 d <br /> N' <br /> a. <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): 6 d�1 .., <br /> Proposed Use of Structure/Addition: E 4,11_/404 r= AODInoit. " 5 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) -i <br /> Building Contractor: S {= Sewer Installer: <br /> 1 r6..., <br /> V_w <br /> ► <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY „�„ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <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,manufactured <br /> home additions,and bunkhouses.** <br /> 0 Ma e4 .4. <br /> << 5e-E& <br /> 1 <br /> �eW -�,vR, fle+ 11 nh6.4,,..4o4 <br /> Fee Rec: iso <br /> a t4Nost,se crc4 ale* exceei j/ �s <br /> 6 t- Check#: g z* <br /> �? L <br /> Date of staff site visit:6 1'%✓/at Initials o site visit of . ,/ 0m <br /> ' ' ,,,,,411,APPROVED BY LAND SERVICES OFFICIAL: DALE; rl5/2171 <br /> r <br /> d <br /> UPON APPROVAL: APPLICAN ` MUST POST COPY OF `-. <br /> <. <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> vC 1%.., o <br /> o <br /> Pagelof5 . z...c '„ <br /> :urnett County, WI Land Use Application- !',ev 05/2022 c EN <br /> x <br />