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LAND USE PERMIT APPLICATION - Burnett County, WI a 2 b <br /> iii .Q� <br /> Applicant Complete All Sections Below This Line o* tq <br /> a- <br /> Permit Types and Fees:(Please,check appropriate boxes) O <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 P <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 .\' 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 N g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> IP <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 t • <br /> Filling/Grading $150 Boathouse $500 II <br /> v) <br /> 11) <br /> Solar Panels(Stand alone or roof mounted) $150 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. 1 ` <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> CT <br /> Property Owner's Name: , ". !�/srak, a. <br /> Property Owner's Mailing Address: 6C.5 <br /> 7y J 4'u',, d22/ L,y;: L.- ► n° `A <br /> City State Zip <br /> Property Site Address: t c7 9 )--,,',•l,, y/ d Vae" ° a <br /> C� <br /> Contact's Telephone Number: j1k)tr/ `,���<":3y K <br /> 3 70-22�Avy9 <br /> Contact's Email: hi, (�✓ e (,,:'d�� (� � ,)'�,�1 '1�'� _ ��3'" r o ao <br /> Legal Description of Property: J4Anf - iJ s VaYy O;f ea., k kJ if v <br /> JJ I 0.Section#: 3. ( Town#: 2- N Range#: ) W Town of: Ste;_f <br /> 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> **�� c <br /> Tax ID#(1-5 digit number;found on tax statement): d a la F <br /> a <br /> � <br /> Proposed Use of Structure/Ac}dition: �./=+�c, 3t ° <br /> Anticipated Start Date: V2/4 /? (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) H <br /> f) � ' <br /> Building Contractor: �0 ( Jwy �'4 54/z.z/,kd�z Sewer Installer: D r <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY V' <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 x <br /> ANY construction taking place for any dwellings,dwelling additions,manufactured homes,manufactured <br /> home additions,and bunkhouses. CI <br /> l� 4/16* � aU ' /,, <br /> 00 <br /> No 1 '�f I/�ecr! IJa4) Fee Rec: /5 <br /> v� vt�e�s ?el'M4S. la/i 1a3 t� bu lie t /-6'7(io <br /> Ey 1�f Check#: <br /> Date of staff site visit: /1 q l 23 Initials f site visits ff: Re <br /> "1 OfeAcil <br /> APPROVED BY LAND SERVICES OFFICIAL• DATE: ` • 2//93 o <br /> r (� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF �W ro ` fill <br /> c i <br /> CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <br /> Page l of 5 3 <br /> Burnett County,WI Land Use Application—Rev 05/2022 <br /> C .� <br /> a <br /> K <br />