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• <br /> LAND USE PERMIT APPLICATION —Burnett County, WI a 2 <br /> b <br /> Applicant Complete All Sections Below This Line a. <br /> c c t.) <br /> Permit Types and Fees:(Please,check appropriate boxes) .-,,z <br /> °' <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 r 0 <br /> Commercial/Industrial Structure $3 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> XAccessory Structure(Garage,Shed,etc.) $150 l Addition/Alteration to Accessory Structure $150 CD <br /> Accessory Structure(Commercial/Industrial 0 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 •° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o N L <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels (Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 I ID <br /> w <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. <br /> CD <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. z <br /> 0 <br /> , <br /> Property Owner's Name: /, a Al , 0 L/ r'S-0 l\ a. <br /> Property Owner's Mailing Address: // c2 .& a W Fre Irl e W; —59g37 n <br /> /j,� /' ��i �} City State Zip <br /> Property Site Address: <O C7 Sil. lid, �2 �rpC ie (i()/ eic?3 `� ° g <br /> Contact's Telephone Number: ilOrrr e; 7/5,-34 7-vies)(C //: VS-1/AD"6 750) d <br /> r J <br /> Contact's Email: D('4 4 1 a.a l d is rYyl epa d.c 6 yv\ N b <br /> Legal Description of Property: m <br /> • <br /> Section#: al t, Town#: 3 7 N Range#: is W Town of: 7ccle �k ' <br /> 5. <br /> 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): 85'9 ,(, o R <br /> Proposed Use of Structure/Addition: &q rage (R.p ploto vie, x I 5 IT Yiq garCiU(a'G) d <br /> Anticipated Start Date: 9—/— a cl, ,-.1,-.1 (Home/Cabin;tommerciatAsiness;Bedroom;Dre'k;'tc.) H 1 c) <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY CI U1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z f _13 <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 bunkh uses.** <br /> 1 �1ca,llj • <br /> ND+;;%( hwYkMt t IediC)IN Fee Rec: � �`,�, <br /> 1ik 4, ecCCcd 204 a Check#: <br /> ✓bY( <br /> I G u <br /> Date of staff site visit: 51/ 9. Ini . is of ' e visits f: f m <br /> ft <br /> APPROVED BY LAND SERVICES OFFICIAL: i /�/ DATE: Nig/102 Fig <br /> UPON APPROVAL: APPLICANTSR UST POST COPY OF a L. 'f), <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT zoo t1=, Fill <br /> { � z N Q <br /> Pagelof5 m N <br /> Burnett County, WI Land Use Application—Rev 05/2022 <br /> m LL---)J0 <br /> 3 <br />