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LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> b <br /> Applicant Complete All Sections Below This Line 0 c to <br /> Permit Types and Fees:(Please,check appropriate boxes) _ � � 1 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 ri <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °- \„.3 <br /> Driveways/ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o N <br /> Filling/Grading $150 Boathouse $500 <br /> E <br /> Solar Panels (Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> E.-- <br /> • <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. C <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. g <br /> �. �% <br /> *Items not listed above will be(treatedas accessory structures,such as:pergolas,landscaping,etc. o <br /> Property Owner's Name: n0 <br /> . <br /> d�2 E. �k t ) Pkitjz.. 6az X1. 3.&Property Owner s Mailin Address: t <br /> it ✓ iXtet <br /> Property Site Address: - I`-'► ,.. elitet3 ° c <br /> Contact's Telepho e Number: LH - sq-S'J — 614( "0 g r 'Te 422- 0.d <br /> Contact's Email: <br /> rt4 fro _Corneas - . ►4f- <br /> � A 0 oa <br /> Legal Description of Property: LA Z esti l lp �� <br /> 0. <br /> Section#: LQ Town#: 31 N Range#: T W Town of: <br /> v. <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): i 0g f <br /> Proposed Use of Structure/A di ion: <br /> oQ T e <br /> Anticipated Start Date: i .22—_(Home/Cabin;Commercial Business;Bedroom;Deck;etc.) •-3� r �..6......� O <br /> Building Contractor: Sewer Installer: c <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z 1 <br /> Po <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 J <br /> home additions, and bunkhou es.** <br /> flee-- a ( Se-� hal <br /> _ i(� L <br /> 1b,`.. NIYV o `'�,Vf J"��� / Fee Rec: �5Z <br /> �Nitrs J- 9 e 4 5:4-e qot�✓�55 /). ( j e� N Check#:� <br /> Date of staff site visit: 9/1q v <br /> (I �' Initials of site visi s a f: m <br /> z <br /> r <br /> p v <br /> APPROVED BY LAND SERVICES OFFICIAL:(4DATE: �t/a1 ' ?)" c <br /> UPON APPROVAL: APPLICANT UST POST COPY OF N n C,) INO <br /> a c r0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o co , <br /> Ifffii <br /> zv o c� <br /> Pagelof5 rn w f <br /> Burnett County, WI Land Use Application—Rev 05/2022 < ' '" <br /> m <br /> v . <br /> Ena <br /> J <br /> x <br /> .v <br />