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LAND USE PERMIT APPLICATION — Burnett County, WI 6 <br /> T b <br /> Applicant Complete All Sections Below This Line F <br /> n <br /> Permit Types and Fees:(Please,check appropriate boxes) 0 <br /> Dwelling/Principal Structure $300 Addition/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 \ ri <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o or , <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ri 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 W <br /> 'w <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. . t <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. r I. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z <br /> �/,, -n <br /> Property Owner's Name: [—+� ` L C S �G`�� O I'ft��8� <br /> Property Owner's Mailing Address: 3 i 0 cl lSLenS,I►-1 41Pe It(.• Cii 4 �'t N S c1.2 'I. 's <br /> L City, State Zip a,p <br /> Property Site Address: (2 c 4 9" Lt-n-L � ''2-4e j t ( ,t f S(->✓ ° r O <br /> Contact's Telephone Number: 6 "2- cc��b(� • 4)6. 3 W o <br /> Contact's Email: p_ll J.X /5-V �W a,b l • cc-rv\ Ne_ <br /> r cf. V1Legal Description of Property: ©T---- ( Z C . W ,_ <br /> Section#: 2.1 Town#: 'VT N Range#: (to W Town of: )�A i)e._ (...A.K2- o <br /> a <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): Z I 7 S o <br /> p p 'T* '�6i✓`c7e--- \-iT�I-k c's ° C7 <br /> Proposed Use of Structure/Ad itio�` 1 �� <br /> Anticipated Start Date:)) F- (t/ "_ZZ L (Home/Cabin;Commercial Business;Bedroom;Deck;etc.)c ^3 <br /> Building Contractor: -e✓!ri JC'Y'+ S s'`OAL Sewer Installer: L%3 l.C„,l j, `,:i' <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY w <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 /> home additions, and bunkhouses.** F:;-() <br /> mee4- All Sei-be 1ts <br /> .iikPV �Id I✓14 owS ,SSSilr- ce c reefile✓r>f Fee Rec:vZb) <br /> n i�� /��' � b��o'�S p€4,0 5 - a•o'�"�l q , Check#: at:66 <br /> ram""" <br /> Q l �f o <br /> Date of staff site visit: 1J''lt ?c Initials f site vis' staff: 4`E--- _ <br /> a <br /> z <br /> . . <br /> ail a3 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: S r Nil <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF m a o3 g 0 <br /> i .... <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o s 0 <br /> z 0. C <br /> { �� ru C <br /> Page l of 5 m 1 ^' <br /> ff <br /> Burnett County, WI Land Use Application—Rev 05/2022 '' a <br /> m ' 1 <br /> cn <br /> 3 <br /> t <br />