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LAND USE PERMIT APPLICATION—Burnett County,WI <br /> Applicant Complete All Sections Below This Line 0 W <br /> Permit Types and Fees:(Please,check appropriate boxes) " Q <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 LID <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/industrial Structure $200 o <br /> X Accessory Structur 6arag , hed,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 Bunkhouse $250 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 S' <br /> Filling/Grading $150 Boathouse $500 .. <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 F. <br /> $ ..1 <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. g <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc z <br /> fa <br /> Property Owner's Name: STUA'RT + ?AMEI_A 0L501J (� <br /> a <br /> Property Owner's Mailing Address: i i ( ILLTO4 9, ,ELL-. LAKE. WI 4 ( ° 2 d <br /> City State Zip <br /> Property Site Address: 5AMC AS A .ovc=T •g i 0 <br /> F. 7 <br /> o. <br /> Contact's Telephone Number: 7-1S -.4 4.8-' -2 S 7- d <br /> a <br /> Contact's Email: s 2-otsors @ i c.toud4 cow\ c <br /> Legal Description of Property: SE S E <br /> 0 <br /> Section#: 3 S Town#: 3 0 N Range#: 14 W Town of: DE W C' zz <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): 3 to -6 W c <br /> Proposed Use of Structure/Addition: (;I)&A(, �‘ 0 o <br /> Anticipated Start Date: S PRANG (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) �/ <br /> ?1023 (� <br /> Building Contractor: N oT DE t_LD E j> Sewer Installer: N/A <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY to <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 zs <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured "'k <br /> home additions,and bunkhouses?** <br /> reeA <br /> DA--car itmoi-ci.� b * S Fee Rec. /50�" '�'v � !o/rP61 � J /� J �����d � I Check#: //!� <br /> Date of staff site visit: I /10 /p 3 Initials i f site visit staff:Hg e 1 <br /> APPROVED BY LAND SERVICES OFFICIAL: j , DATE: 1111 123 ri ,b <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF y g'= D 0 <br /> co fil <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o 0 CP-0 <br /> Page l of 5 p `,' <br /> Burnett County,WI Land Use Application—Rev 05/2022 a {, <br />