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LAND USE PE '"IT APPLICATION -Burnett County, BVI ar <br /> y ; !J <br /> Applicant Complete All Sections Below This Line °o. N <br /> CD I <br /> Permit Types and Fees:(Please,check appropriate boxes) , ' a �}�j <br /> 1 <br /> ,--6 _ <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 , CI <br /> - <br /> CD <br /> Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 )Q O <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 i .� g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 --...., <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0C)<,, . <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ; o <br /> Filling/Grading $150 Boathouse $500 <br /> cn Ob <br /> Solar Panels (Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) _$100 ' <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. ICD <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. g <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> --ar (C 4(dtIe cm 14 \Rte F o <br /> Property Owner's Name: a. <br /> Property Owner's Mailing Address: W, a- -1 d) r1. SUn e-4 CcA �p,ctetr C_`-j 1 521837 S. n <br /> ��!!��ii City StateZip <br /> Property Site Address: le��- One-1.. -• i-dc-t-8- y i[i C- W,--5-11-e-13 7 g 70 <br /> p `?�'�-(`f7�1/`-f 75-7 4Ll7- 13(3e a. <br /> Contact's Telephone Number: d <br /> ue, Zdn_' n'e-� .. <br /> Contact's Email: 1/)-N✓l �a r j pcf t N b <br /> 0 OA <br /> e. <br /> Legal Description of Property: /,( T I ' # /.3(06 V7 PR3ao <br /> 1 C. <br /> Section#: ..3._Cj Town#: 3e) N Range#: /5 W Town of: I d1 " <br /> 5'. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): IV t q 2 o H <br /> Proposed Use of Structure/Addition: Pdl.e.Li-u ( rUs e v`�rCc e JL-1)4- Li0 6 <br /> Anticipated Start Date: -���C__? �- e/Cabin;Commercial Business;Bedroom;Deck;etc.) ,-3 <br /> Building Contractor: gar I Abe(e Le-- Sewer Installer: ndry•e- 4 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> ;all <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: zlJ**The applicant needs to contact their UDC Inspector to determine if a permit is needed from them prior to <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured <br /> home additions, and bunkhou es.* <br /> Wheel- a.tl <br /> a Wc.4 ham' �: { ,1- ex ;irsh'cv b� �`�' <br /> llt12 -. r _ �e! " Q Fee Re <br /> reel- <br /> AC S r J��6 , Y I [ y Check#: .2b$q. <br /> Date of staff site visit: $I lel??- Initials o site visit to �D <br /> . . k 0 <br /> r' <br /> APPROVED BY LAND SERVICES OFFICIAL: 0 A 1 p �� DATE: �! lgl w <br /> UPON APPROVAL: APPLICAN i MUST POST C SPY OF n co <br /> 1fa c...) i <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z y � r <br /> =c 3 << <br /> Page I of 5 a --��, <br /> !:carnet County, WI Land Use Application-Rev 05/2022 < a �� <br /> v <br /> tn <br /> a <br /> 3 <br /> �e <br />