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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line o• c t� <br /> Permit Types and Fees:(Please,check appropriate boxes) a (� <br /> d <br /> Dwelling/Principal Structure $300 XAddition/Alteration to Dwelling/Principal Structure $200 v <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 . � 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 s <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 g k) <br /> su <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 a. <br /> *NOTE:After-the-fact permits (permit aqui red 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. o <br /> -11 <br /> Property Owner's Name: 7 'n H ,'. /a4 V i�Q+rf,,. /� � '� a (v <br /> Property Owner's Mailing Address: 02 `+' /1� Z *S/477 T)- til e. + - W5/�. F. n -(--/ <br /> City State Zip ''� Cc <br /> Property Site Address: S 2 i <br /> 715`— 0)�ro / ��` a ' <br /> Contact's Telephone Number: �r d —, <br /> Contact's Email: iip(� a Ys e v#A-Ae„..-e). e2 ..". `- <br /> N ago CI) <br /> Legal Description of Property: N> -e KC 7L,/te o <br /> Section#: S Q i Town#:7 390 N Range#: /1W Town of: 41h 0 ✓ 0, N <br /> m.o <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> cn <br /> Tax ID#(1-5 digit number;found on tax statement): gspi oH H <br /> p Fid+• room' oZ 7A-5)_ t7 <br /> Proposed Use of Structure/Addition: / <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) -3 <br /> Building Contractor: I3I gJ.. 1 � 40- Sewer Installer: O <br /> W <br /> AREA BELOW THIS LINE FOR LAND SER ICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: Zi <br /> - 1 <br /> pzJ <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,diLand bunkhouses.** <br /> 8114q/�e. Sure, 7`0 2 //5 Wile" SEms/ �+ /s�/ — D p• °,) <br /> 3 4e�� PWS e-# JI/(/� 2 2 ' Fee Rec: <br /> hof f o exc� P <br /> Check#: e.));)e.));) 7 if <br /> �' o <br /> Date of staff site visit: C„ ZZ 20 Z Z Initials of site visit staff: ,//r _� <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 6/"0e92'2i i <br /> t_ I ti <br /> UPON APPROVAL: APP ICANT MUST POST COPY OF gb of <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 o ' ' `Ci <br /> C <br /> Page 1 of 5 N I <br /> Burnett County, WI Land Use Application-Rev 05/2022 rn; <br /> Ji <br /> i <br />