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LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> b <br /> Applicant Complete All Sections Below This Line = a N <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> C7 <br /> .j <br /> Dwelling/Principal Structure $300 X Ad ition/Alteration to Dwelling/Principal Structure $200 �; <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 co <br /> AccessoryStructure Commercial Industrial F }Lj(Commercial/Industrial)) $200 Addition/Alteration to Bunkhouse $150 � <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °e <br /> ! Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> 07 0 <br /> Filling/Grading $150 Boathouse $500 <br /> rn <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> i <br /> *NOTE:After-the-fact permits(permit aqui red 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. or g <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> 0 <br /> Property Owner's Name: Christopher and Michele Lacy a a � <br /> -0 `te <br /> F. a <br /> Property Owner's Mailing Address: 28578 Birch Island Lake Trail Danbury WI 54830 N <br /> City State Zip < <br /> Property Site Address: 28578 Birch Island Lake Trail Danbury WI 54830 ° G <br /> Contact's Telephone Number: 715 431-0184 d <br /> Contact's Email: dan©upnorthcarpentry.com <br /> N R <br /> Legal Description of Property: LOT 10 CSM V26 P199 (GL 7) g' ?J <br /> F. <br /> Section#: 18 Town#: 40 N Range#: 14 W Town of: SCOTT t <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): 34800 ti <br /> Proposed Use of Structure/Addition: Porch Addition and Deck so i�C <br /> Anticipated Start Date: 10/15/2022 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Up North Carpentry, LLC Sewer Installer: N/A .- R 'I— <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> **The applicant needs to contact their('DC Inspector to determine if a permit is needed from them prior to x <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions and bunkhouses.** �i.C�'J � �"v Thee+ ct« 5410 ,� . � 3��� <br /> eake.1(4`3,- (A- �c a f /IN Fee Rec:4355141 <br /> Check#:/lj%! <br /> 0(3��2— m Lva3 / <br /> Date of staff site visit: Initials of site vis' s `�E. lu/021/ , <br /> APPROVED BY LAND SERVICES OFFICIAL:(/ � "V' , DATE: 10/ 11/7-? tr, <br /> 7, Li,L):::-.) <br /> 4' <br /> UPON APPROVAL: APPLICANTMUST POST COPY OF y �,, itftt <br /> y 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o � ' <br /> zr <br /> r,.aIMO <br /> n ti <br /> Page lof5 ��l r C <br /> Burnett County, WI Land Use Application—Rev 05/2022 ' <br /> 3 <br />