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LAND USE PERMIT APPLICATION—Burnett County, WI a <br /> Applicant Complete All Sections Below This Line NJ <br /> PP mP , <br /> Permit Types and Fees:(Please,check appropriate boxes) dc'. <br /> Dwelling/Principal Structure $300 I Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 .J O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 A <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 .-- <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 b <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 II, <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three tins the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. o 5 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc c <br /> Property Owner's Name: Q ii <br /> Property Owner's Mailing Address: I0-hc'q1044k S, TiVLt i rn nie X71 . n VP <br /> ' City State Zip <br /> K <br /> Property Site Address:,,)--13-11` -.STD 1 W E ei'- �L--1-(13 <br /> Contact's Telephone Number io t a g l 1 Q log t4 .. <br /> Contact's Email: !V•41-14,Luk .fYlit.l14-( hfD, M'Yi <br /> p 4 I <br /> Legal Description of Property:FRI a Y`� I ?c ,4146. E.OF in V g. .) a.. ,f <br /> Section#: 33 Town#: eta, N Range#: gib W Town of: orktitt.11 N <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): 13c1 3l W c <br /> P L� iN d ii;7i' <br /> Proposed Use of Structure/Addition: ,0A- <br /> Anticipated <br /> � <br /> Anticipated Start Date:? d, (Home/Cabin;Commercial Business; room;Deck;etc) I H <br /> Building Contractor. ©01'e 7 Sewer Installer / �� O <br /> Q <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ._,p <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: A W <br /> z <br /> **The applicant needs to contact their UDC Inspector to determine 11 a per mit is needed from them prior to <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes, manufactured <br /> homeditions,and bunkhouses.** r <br /> 6 <br /> N./- 7o e-?cce.e� Z 6e 0`445 �u'' cavi1Ye/7#3Z?7gI <br /> 0 4,./.. f,c%cv 7 4, 6G IN ///r.r m4 SVhL r "i-e%7 y /o//J7 ZZ• Fee Rec:A fj0 <br /> 0CnA710 - utL -Nspeerler 71.0 v�e 1 1 r'1' � Aced cr pemim I o , Check#: 11 (p si <br /> Date of staff site visit: 9//Z/24 a 2-Initials of site visit staff: ifilr c, <br /> rn <br /> CD <br /> APPROVED BY LAND SERVICES OFFICIAL: 2"4"-- —,("4-"--'-- Q DATE: ` /3/Z40 ZZ :r_in r <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF Wit <br /> " U0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT = '=' <br /> .i1 re), <br /> .� <br /> Page 1 of 5 r=', 3 "' <br /> Burnett County, WI Land Use Application—Rev 05/2022 <br />