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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> 2 b <br /> Applicant Complete All Sections Below This Line 0 j <br /> Permit Types and Fees:(Please,check appropriate boxes) °• <br /> CJ <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 FO <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 V.) O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ..-- . <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk X Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 ' <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels (Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 a <br /> *NOTE:After-the-fact permits (permit aqui red after construction has begun)may cost up to three times the normal fee. . r <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. 0 g - <br /> *Items not listed above will be treated as accessory structures,such s:pergolas,landscaping,etc. o <br /> Property Owner's Name: J r;ini �'I .C`l it pp ohe - n , -� <br /> I <br /> /, i��� qp1 . Y <br /> Property Owner's Mailing Address: l 3-1 .�.� rem j e , i l��'I-G ll�i I Le 6'If� 4�y 5. <br /> ko. PP <br /> City "State Zip -c t <br /> 31� E 11 G ) 4 �*t o 1 <br /> Property Site Address: f t� 1.�-� '� C <br /> a. <br /> Contact's Telephone Number: 507 3 O —O S92- d„ - <br /> Contact's Email: ty 60)50 y,1400, e_clas ' <br /> �+ o cm <br /> N -o <br /> �-Legal Description of Property: LOT S+M"1 V S r(J Z CLTt tors)or�� E. <br /> Section#: 35 Town#: Li C2 N Range#: 5 W Town of: k c)/) 0. <br /> 5. <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):60 o ,- <br /> Proposed Use of Structure/Addition: Gc /f Sf c Bat kv''�s e- tr( d <br /> Anticipated Start Date:.�t;/t (Home/Cabin;Commercicrl(�usiness;Bedroom;Deck;etc.) --3 <br /> Building Contractor: Lee. "Ce l'A l( Sewer Installer: 11p1 ��k5 s <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> pci <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 unkhhouses.** &talc( i pµfe ci,gq freinei3�' <br /> 1 iylee+ 4II_se c115 l%% {+o�, V�/ �+ per - fie- �,,, <br /> a ?„1-a/-f,(eQ,-1- arm 4 1AAII(tAj ,4 -Jie64 o� f <br /> ►�edho✓ d DC �i Val�pnCe(/5�'��-jt� 8111?3, Fee Rec: ; I C-� <br /> !V I .se Can ►col• Oee,e 3 br. o^� ei shill- 3.0 Li ' Check#:` 1 <br /> Date of staff site visit: I I ) 2./a-a Initials f site visit staff: N -t k 1 `ri <br /> a (1r-7Th <br /> (( C <br /> ��� <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 3 7I �� foul E <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> c... o 0 <br /> a :xa U, <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTrum <br /> O C.4 c U <br /> -< C-) 03 co <br /> Page 1 of 5 A ,psi `� <br /> CZ <br /> -J <br /> Burnett County,WI Land Use Application—Rev 05/2022 <br /> rr,y <br /> i <br />