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LAND USE PERMIT APPLICATION — Burnett County, WI 5- 0 <br /> Applicant Complete All Sections Below This Line 5 g Ic�l� <br /> Permit Types and Fees:(Please,check appropriate boxes) J a. W <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 F <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 ` i <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> g �J \b <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk& Bunkhouse $250 ,Vv`)( <br /> v <br /> Driveways/ CampgroundStructures $125 WI State Statute 59.692(1v)Structures $350 o W <br /> II <br /> Filling/Grading $150 Boathouse $500 • <br /> k <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <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. `r g, <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. z 1 <br /> p <br /> Property Owner's Name: `I SHLEY AA ict>2-1/4( $ <br /> C <br /> • <br /> Property Owner's Mailing Address: 2•SO 9 3 S-h' /4 V- 5 /Yl pLS /YIN r5 c O Co - <br /> City State Zip <br /> Property Site Address: 2-6 II o 5 . Li P 5 Err U gE P RD-, S a o N £ t (,e1( S'y e e J <br /> c <br /> Contact's Telephone Number: 41 S 2 - 2'0 - 688 o <br /> Contact's Email: al S k le I'ltu-1 WI�c..t l• C Gv✓7 tc`r°�`'� i►� <br /> �f ya,�f VcI. 1 . . z12 0 <br /> Legal Description of Property: l oviC c I A c Ce d{ • S u r4-e.1 M6f �0. 2 0 C. u s Do a. 1�. '. <br /> 1 `oG21 0 <br /> Section#: i ', Town#: 3 "\ N Range#: I L4 W Town of: f'p-U S 14- ,. <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): I S 1 1 b <br /> 9 o x <br /> W <br /> Proposed Use of Structur A��1-e�ddpition: p e C t d <br /> Anticipated Start Date: Lk (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) •i " ---- <br /> Building Contractor:/1%/G CC r""-",E N I-/A L.L Sewer Installer: W <F ° <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 theirI DCIn pector to determine if a permit is needed from them prior to 'v <br /> ANY construction taking place far any dwellings,dwelling additions, manufactured homes, manufactured <br /> home additions, and bunkhouses.*' I <br /> a <br /> �1eCA- 4 ti Set (ed 1131 I ,3. Ne•,, Qazew4( co✓11%4µ� <br /> $Gwr+ }c,ri✓J I~en-k Ipetal. . o`"tf- CA bliA , <br /> ^ ,�E. a iruPe(VI cLc 54.i ce vtloµ(C( ,iNe i'YIfi 4fi .i Z5 Fee Rec: � <br /> 'l/��- Qi�:� ✓✓I� c� Check#: / ) <br /> tz <br /> Date of staff site visit: Z)-0 2-3 Initials o site visits ff: I- m <br /> I> <br /> 2 <br /> 3111a.3 APPROVED BY LAND SERVICES OFFICIAL: DATE: a �- <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF &r m 0 <br /> n D CO <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT c J u C <br /> 2 -O f—� <br /> r CDC N <br /> -c-2 • O 2, <br /> Pagelof5 '- v <br /> nil <br /> Burnett County, WI Land Use Application - Rev 05/2022 < R. <br /> 1 , <br /> C <br /> c <br /> a <br /> ro <br />