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LAND USE PERMIT APPLICATION—Burnett County, WI <br /> • ,,licant Co Mete All Sections Below This Line s c N <br /> a <br /> Permit Types and Fees:(Please,checkappropriate boxes) <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 I v <br /> S):$ <br /> Commercial/Industrial Structure <br /> $300 Addition/Alteration to Commercial/Industrial Structure $200 { 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 I a, <br /> ~ <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 1 _ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 I o v <br /> Filling/Grading $150 Boathouse $500 Iir k�`( <br /> 4:: <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. I ro <br /> *Communication Towers&Signs require a different application fom see corresponding application,and fees. 1 rr. g <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. i z ((� <br /> ' o U� <br /> Property Owner's Name: -5 f ( 'I r p'€ 8-e.S-e r a <br /> Q nti�� b � f <br /> Property Owner's Mailing Address: 1 L� / 0 Lr C �IwiQ' C A ke ct A l✓i S ir6 = n <br /> ^� u City State Zip c _ <br /> Property Site Address: O/7 0 0 (J. C et A/Ado S L or k t �d o r <br /> r G, a' <br /> Contact's Telephone Number: 1 I S -e) b; — c o is v <br /> Contact's Email: co -e e P A t/ I S 4e" 49O e CoPct.' v e �a� o -o <br /> Legal Description of Property: GoV 4 tS De .SO7/f91 c9; V', '. <br /> f v <br /> Section#: 35 Town#: 4 D N Range#: Y/ W Town of: utkl4m.ti re <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* �1 <br /> Tax ID#(1-5 digit number:found on tax statement): L —7 '-3 --i <br /> l o 0 <br /> Proposed Use of Structure/Additi n• G A c t e. 4- S h 0 Q v <br /> Anticipated Start Date: S C P f , 0 Z (Home,/Cabin:Commercial Business;Bedroom:Deck;etc.) <br /> Building Contractor: t)I yV k Ad c t‘,4",N, ' '-f + Sewer Installer: Co (T alcie esop- - <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 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 bunkhouses.** <br /> t►1ee) all 5e4-bc,&' � 1 <br /> Nth Svc hu,vutan habt-�►fi� l�l�aj <br /> Fee Rec: <br /> � <br /> Check#: 4, <br /> Date of staff site visit: 11a7/? Initials ofsite visit,. Z----/ Air' ` m <br /> f / <br /> APPROVED BY LAND SERVICES OFFICIAL: / DATE: 7! 2�! ?? r <br /> • � w r1 <br /> UPON APPROVAL: APPLICA % ST POST COPY OF CO `c 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT g <br /> 0 7 N O <br /> Ca <br /> Page 1 of 5 ,, a zN <br /> Burnett County,WI Land Use Application—Rev 05/2022 < s>> �� <br /> w <br />