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LAND USE PERMIT APPLICATION —Burnett County, WI 0 <br /> N <br /> Applicant Complete All Sections Below This Line ° a w <br /> Permit Types and Fees(Please,check appropriate boxes) C7 .-- <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 N <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p <br /> W <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n <br /> o `` <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 (U�+► <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o Q <br /> Filling/Grading $150 Boathouse $500 En <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 9 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. 1 <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. CD ? <br /> 7.--:\ <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> 0 a <br /> Property Owner's Name: 4s or ', T rut /-jf Mpe / g J4. <br /> 15 <br /> Property Owner's Mailing Address: 30 225 R,-yam uaad i--'e SA4 - /wv. 5"1� 79 1 ( <br /> �;�� City State Zip <br /> Property Site Address: a 3 Yes'9 5 ite r'Sort Reerd o y <br /> Contact's Telephone Number: (467— 3 Z q `5'4,a 0. <br /> d <br /> Contact's Email: J he w,p.e I Sery I°c eSLLc e 1 Pt/a+ [ lo.� J <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ,0 <br /> legible and your email provider will accept emails from the following addresses: @BumettCounty.org and =, 04 <br /> 5 <br /> @BumettCountyWI.gov °0 <br /> C. 2.) <br /> 7, <br /> Legal Description of Property: <br /> Section#: 2-2- Town#: 39 N Range#: /(c W Town of: PieK/10+" v, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ' , il) F H <br /> W o d <br /> Tax ID#(1-5 digit number;found on tax statement): 3503' W <br /> Proposed Use of Structure/Addition: +o r c ye / 4 v a s , u,.s z <br /> Anticipated Start Date: a I i lap a3 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: NOri-hto,nd gwsldl /.55 ,znt_ Sewer Installer:R;6 kits ' <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDI ONS ONLY <br /> THIS PERMIT IS ECT TO ALL CONDITIONS LISTED BELOW: <br /> ;r. 1 h ha�,-'a19 64 (2I • <br /> I el flee ` � RI Rec.I ,1 t/) <br /> y-r <br /> 9.� 'f 1�� vCheck#. 4,Ol(-1GAS �l '{a� CDl4� m <br /> z <br /> I, v <br /> Date of staff site visit: 1l31 I 93 .i is/. of,/staff: { r - ��J <br /> 4 C <br /> APPROVED BY LAND SERVICES OFFICIAL: MI a13/a3 DATE: a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o 3 z <br /> z cu r: ry EN <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT z 0 m <br /> _ rV <br /> Page 1 of 5 " ` w <br /> Burnett County, WI Land Use Application—Rev 12/2022 0 <br /> X <br />