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LAND USE PERMIT APPLICATION - Burnett County, WI r <br /> I b <br /> Applicant Complete All Sections Below This Line a N <br /> Permit Types and Fees:(Please,check appropriate boxes) ' Tr <br /> vi <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwel I i ng/Pri nci pal Structure $200 ad CAI <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <°- <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1y)Structures $350 c p <br /> .. <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. — , <br /> b <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> o <br /> wane. ,Cke,'C v <br /> PropertyOwner's Name: 0 <br /> rr�� Circle <br /> j C / a <br /> Property Owner's Mailing Address: I9 CIrcle S,o Cod- aegGou�e Pin 6-JC�1. ° n <br /> City ate _Zip C <br /> Property Site Address: <br /> S9 Cranberry J QKe Sri ve ba u)► �8. •o y <br /> a <br /> Contact's Telephone Number: 6SI '4Sq'697 t7 <br /> d <br /> Contact's Email:ECXed y&COr»CAs fy <br /> . ine 4- N b <br /> Legal Description of Property:Sae fr -j ched on Qr\v-Icx\ Perms a"o <br /> Section#: Town#: N Range#: W Town of: $ 1�/ r5 C <br /> iA <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ..1 :) <br /> Tax ID#(1-5 digit number;found on tax statement): 2 Z 33 I c w <br /> Proposed Use of Structure/Adf Q�diti n: i`G r� d <br /> Anticipated Start Date: q'�/3 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) H <br /> r „.., <br /> ,,_, <br /> Building Contractor:/W'j'er /4oirS CrfirUCtlonSewer Installer: A`A -C �, <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY r— VI <br /> .1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> ""The applicant nee to contact their UDC Inspector to determine if a permit is needed,from i/win prior to �'ds <br /> .1e\Y construction taking place for tiny dwellings,dwelling additions,manufactured homes,numufnetured <br /> ydithms. <br /> and hunkh uses CSC <br /> }1 'h Y0 Q . (Ls r <br /> FeeRec:�� o v r�' L y Check#: �L 9 <br /> 0 <br /> Date of staff site visit: 1 • ials f site vi a <br /> 0 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: to/1o( '-- <br /> r <br /> UPON APPROVAL: APPLICAN UST POST COPY OF a c' N ` <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT Co ffl1, <br /> Page 1 of 5 . ; C <br /> Burnett County,WI Land Use Application—Rev 05/2022 < 1 "' M. <br /> " c <br /> ro <br />