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Firefox about:blank <br /> C <br /> LAND USE PERMIT APPLICATION — Burnett County, WI 7 <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and Fees:(Please,check appropriate boxes) <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 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 � <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ° <br /> Filling/Grading $150 Boathouse $500 <br /> . cSix Month Camping Unit(One Per Year) $100 Permit Extension(1 Year Extension-Allowed Once) $100 <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. <br /> *Items not listed above will be treated as accessory stbri <br /> uctures,such as:pergolas,landscaping,etc. lV <br /> Property Owner's Name: as-e._& t c TQ e r c <br /> Property Owner's Mailing Address: Ia 5 I ;3 4- Q 12J c�'isurs�'f�ut�� ,o <br /> =::- iis <br /> 6. <br /> City State Zip _ <br /> Property Site Address: <br /> i j- 13 I -c�(7a <br /> Contact's Telephone Number: _ <br /> 14..: <br /> Contact's Email: at' ' - 0 e r^e . WAC, 1 . , . An <br /> ----\,., <br /> Legal Description of Property: LD-- I C5111 V j/ P NI <br /> y <br /> Section#: . a Town#: 3 7 N Range#: ) $ W Town ofj-IraOlr e- ljA- <br /> 45, <br /> Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C <br /> H. <br /> Tax ID#(1-5 digit number; found on tax statement): .2 LI I 18 <br /> Proposed Use of Structure/Addition: SLJ /5+-0 CQq e ') <br /> Anticipated Start Date: 5 -2 0 ^2 Q a a ` ,,,„„e„-„,„,:t410„„,„,.„,8„,„„,„,,,Bedroom:Deck:etc.) 1::"5 j <br /> Building Contractor: / J'//. Sewer Installer: J /P\V <br /> y / Z C <br /> AREA BELOW THIS LLNE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: (t <br /> • <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 z r <br /> home additions,and bunk!ouse .** � <br /> ^ <br /> �ee-I—al( .kfb 5, Co <br /> N�- ,L 4b,kh, 7) <br /> ld��/�-� d 5 <br /> Solar arra /1eec (Q use pe/ bo �,,�(� rr? <br /> v Fee R 341 <br /> r,... hec6Cti4 <br /> Date of staff site visit: .545 I?-9- Initials o site visit staff. j], __ z m <br /> ..//4 ...,,t <br /> APPROVED BY LAND SERVICES OFFICIAL: `e -, i DATE: r— o'o <br /> A V v, <br /> UPON APPROVAL: APPLICANT MUST POST COPY z <br /> IN03(13 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTuUu T <br /> 1.7 V <br /> I ' f <br /> 1 of 5 5/20/22, 1:13.1)1v. <br />