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s <br /> LAND USE PERMIT APPLICATION-Burnett County,WI g ( 54 <br /> m m �J <br /> Ap)*anf Cep ether BeIow T• #:r e g =s N <br /> Permit Types and fees:(Please,check appropriate boxes) 1 a. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> It; E. <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 <br /> ?c, <br /> AccesoryStructure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 '. g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 > 1 <br /> Deck/Stairs/Patio/RetainingWali/Sidewalk `Bunkhouse $250 1 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 6. P <br /> Filling/Grading $150 _Boathouse $500 .� , <br /> m <br /> rSolar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 § <br /> NOTE After-the-fact permits(permitaquired after construction has begun)may cost up to three times the normal fee. o <br /> K <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. g 1 <br /> 'items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o , <br /> Property Owner's Names i Q (} c s- 1 J-5 <br /> Property Owner's Mailiag Address: I ; 4 I S--) OW") Sy s. bg. M <br /> tty c <br /> Property Site Address: _) � 7 5- a I CI S h- -- . s. s. <br /> Contact's Telephone Number: 1/ S- Co c6-- 3 0 ?0 ` rV <br /> 1v <br /> Contact's F.maTh n c i < . G U b <br /> Legal Description of Properly: Cli-0.a -a - 4 J 4(i-D 2-1 04-03 0- 14E 000 of <br /> Section#: Town* Li N Range# (v W Town o .S_Vr1 if <br /> *Attach additional page ifneeded for lengthy description OR attach a copy of the deed OR attach tax system property page.* a <br /> ra <br /> Tax ID#(1-5 digit number,found on tax statement): cP.c 0 $0 o <br /> 1 11 r3 i <br /> Proposed Use of Structure/- .. ,,i• r 1(..V I C. Pi9 \3 i it I UV) <br /> Anticipated Start Date: /0 /T '7 - _ (ffome/Cabm Commercial Business;Bedroom;Deck etc) i "3 �1 nn <br /> BuilclingContiractor Contractor r S \,)%4(f-•-� ►( Sewer Installer: 0/4 N \ <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 Ps <br /> ANYconstruction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkhouses.** <br /> Fee Rec: <br /> Check#:vp <br /> a <br /> 0. <br /> Date of staff site visit /D/6/ZQ ZZ Initials of site visit staff: //, K/1 tA <br /> t <br /> / 8 [ 7 � <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE l r/ Fill <br /> UPONAPP O AL ,APB. N *O "COF O. m <br /> -12 <br /> S E_ ONNP . :SI0GT gm <br /> Page 1 of 5 a 2 <br /> Burnett County,WI Land Use Application-Rev 05/2022 <br /> • <br /> L ) <br />