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LAND USE PERMIT APPLICATION—Burnett County,WI = C <br /> ro <br /> U <br /> Applicant Complete All Sections Below This Line 3 1 c tN <br /> Permit Types and Fees:(Please,check appropriate boxes) I a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 1 ti <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ..Atr'' <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 ' i V�+� <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 `) <br /> • Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 , !/�vV <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 b i" <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 ' p <br /> .5 -- <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. 1 ry 1 <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. ; 3 j <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,s,landscaping,etc j I-- <br /> Properly Owner's Name: (4.(� i n��U 1—, <br /> Property Owner's Mailing Address: P6 ' l,DL rj C WQ- l � kS ;� 7 <br /> City State Zip 1 <br /> Property Site Address: C� �-- �I <br /> Contact's Telephone Number �f\" D,��- D� I 01 C <br /> Contact's Email: C4% W1 \ L ,N <br /> B' m <br /> Legal Description of Property:Lt+ k, (,t'J'M 44 1�S-� 46 P32,0„It:10 0 Y I <br /> Section#: r5 Town#.j L/0 N N Range#: (p W Town of: f bt!�- - at fzim 1/0 1 1 <br /> *Attach additional page if needed for knoll?description OR attach a copy of the eked OR attach tax syvem property page.* j d <br /> Tax ID#( g nuttiber found on tax statement)_ C7.1 "DLO"a"Lt)-)b aQ "5 6S(,b-dll CC I <br /> ° y <br /> Proposed Use of Structure/Addition: NC),(-- - .0, Y'U\.' 1.ecLs-VbSAwe i- C 1°0 C <br /> Anticipated Start Date: a�yueyk- Cy' .--• (Home.Cabin:Commercial Business:Bedroom Deck;etc.) '-3 <br /> Building Contractor: ‘S-eA,, , Sewer Installer: <br /> id i !1546 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ! j <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <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 /> h, additions,and bunkho es.** <br /> ©0 Aid sa se tel too fats v,/l s�,fc DS p5 J� <br /> Fee Rec: itP5— <br /> p e� / . Check#: /// (p9 <br /> Date of staff site visit: 1`V?I I Initials o•site visi , / <br /> APPROVED BY SERVICES OFFICIAL: I - �/ DATE31127/ ? 0 <br /> UPON APPROVAL: APPLICA MUST POST COPY OF J <br /> r <br /> g 50 <br /> (J <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTw W <br /> K Ci.- (n <br /> Page l of 5 M o o c-ri <br /> t1 toj <br /> Burnett County,WI Land Use Application-Rev 05/2022 _g 3 c <br /> y 3 <br /> 3 UuU <br />