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A <br /> LAND USE PERMIT APPLICATION — Burnett County, WI CA <br /> ro r <br /> Applicant Complete All Sections Below This Line o* cN <br /> a.PR.rmit Types and Fees:(Please,check appropriate boxes) F V' <br /> r Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 rn If--- <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 �1l'4)lO <br /> 1. Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 r <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 y <br /> Cl <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 1 <br /> I ° d I� <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 I <br /> Filling/Grading $150 Boathouse $500 <br /> v) <br /> t. <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. -o aVr <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. 9 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> D <br /> Property Owner's Name: A-/tm/v/* v._. GI. `7-S, T e2t.i`-- <br /> c <br /> Property Owner's Mailing Address: L//(p/ kb 13 /"- A _14„ <br /> �y � City State ,Zip < _ �1 <br /> Property Site Address: 3/ 2.L/ kl7IS77-d'i-t /\JJ (,JEST t 2Z Sit f ? �� ° j �0/" <br /> Q a <br /> Contact's Telephone Number:_ 6/).-- 6� 7 9./3 d <br /> Contact's Email: A.13 our 6? 7 '-1c ACT-Iry 7— N <br /> • <br /> l <br /> Legal Description of Property: Le/ Lj C,S 11"7 # 7 "f 7)c,20;6 v <br /> Section#: Town#: N Range#: __W Town of: SGZT <br /> I <br /> I <br /> — <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): le),/6, ,::::) r <br /> Proposed Use of Structure/Addition: MOO S 6 zry ^ � <br /> Anticipated Start Date:�S?�/ >`t✓ Z� (Home/Cabin;Commercial Business:Bedroom;Deck;etc.) ^� VJ I r,y <br /> Building Contractor: <br /> Cal--7 Sewer installer: is I,;1-'-...S <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z C%-...."' <br /> **The applicant needs to contact their CDC In.spector to determine if a permit is needed from theta prior to <br /> ANY construction taking place for any dwellings, dwelling additions,manufactured homes, manufactured <br /> home additions, and bunkhotts <br /> $t/0 <br /> ti '-�i'a.11 <br /> - IA,Ad art 6 b 4)' _, Fee Rec:/Check#: / Q:07t) <br /> Date of staff site visit: / e ma Initials f site v��� n <br /> �j y z <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: `�/ I v cnrn <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <br /> 0' n cc U U U <br /> Pagelof5 ,c,ti o <br /> Burnett County, WI Land Use Application—Rev 05/2022 , m ^) <br /> • ' l(lf <br /> b <br />