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LAND USE PERMIT APPLICATION - Burnett COuti , WI a C <br /> IV <br /> Applicant Complete All Sections Below This Line --_ cD c <br /> i Permit Types and Fees:(Please,check appropriate boxes) c... ' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 v hV <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 �-� <br /> x Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 Iq` <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 g ,3 ��. <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ' ° 0 �, <br /> al <br /> Filling/Grading $150 Boathouse $500 c d <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 ..."' <br /> c <br /> *NOTE:After-the-fact permits(permit aquired after construction has begun)may cost up to three times the normal fee. g <br /> *CoMmunication Towers&Signs require a different application form;see corresponding application,and fees. i <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. I CD <br /> 1 <br /> Property Owner's Name: Bailey Green b z <br /> Property Owner's Mailing Address: 24249 Nelson Road Webster _ WI _ 54893 <br /> i <br /> ------------------------------------------------- <br /> City State Zip s I <br /> Property Site Address: 24249 Nelson Road, Webster, WI 54893 • <br /> E <br /> Contact's Telephone Number: 715-791-8097 c U <br /> n <br /> Contact's Email: baileyiordangreen@gmail.com__—_ _ <br /> CD <br /> � <br /> Legal Description of Property: Home —__ ' <br /> Section#: Town#: _N Range#: W Town of: LaFollette = <br /> 6. <br /> *.Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* c <br /> F;Tax ID#(1-5 digit number;found on tax statement): I <br /> I.Proposed Use of Structure/Addition: PV System Around mount '" <br /> Anticipated Start Date: 10/12/20 (Home;Cabin;Commercial Business:Bedroom;Deck;etc.) c x <br /> Building Contractor: Wolf River Electric Sewer Installer: r- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> `The applicant needs to contact their C,'D(1'Inspector to determine if a permit is needed from them prior to <br /> d-Ai F construction taking place for any dwellings, dwelling additions,manufactured homes,manufactured Z ii <br /> home additions,and htrnkIiou,si'+ ** <br /> � I <br /> ab <br /> Fee Rec: <br /> /,� Q' 6 Check#: v <br /> Date of staff site visit: /(/ p ' .Initials of site visit staff: tr,y <br /> r <br /> ` / Bei ��� <br /> APPROVED BY LAND SERVICES OFFICIAL:% a'CTEr t�O l,0 19-_ g <br /> U -SON APPRO��AL: APPILUCANT MUS�,� POST COPY OF y <br /> nc.:::, ff <br /> SIGNED PERMIT APP _�I C F I O G N IN PLAIN SIGHT 0 o 0cyi <br /> Transcendent: - Page 1 of 4 �3 an <br /> Laserfische: Burnett County, WI Land Use Application—Rev 6/2020 tri <br /> m <br /> a <br />