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LAND USE PERMIT APPLICATION —Burnett County, WI `° r <br /> ro <br /> Applicant Complete All Sections Below This Line 0 c w <br /> Permit Types and Fees(Please,check appropriate boxes) �. <br /> b <br /> g. <br /> Dwelling/Principal Structure $300 X Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 e't. O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> ) e L— <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> C <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c- p <br /> Filling/Grading $150 Boathouse $500 II <br /> v) <br /> ra <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. FP <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. @ <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> Z k' <br /> p <br /> Property Owner's Name:John and Mariane Hartley 8 ai <br /> y <br /> a <br /> Property Owner's Mailing Address: 28520 Kilkare Rd Danbury WI(Northland Builders Inc) 54830 e, r) d 0 <br /> City State Zip ° <br /> Property Site Address:28970 Sweger Rd Danbury <br /> °-• C 1Contact's Telephone Number:715-259-3257 0. <br /> o <br /> Contact's Email:northland001@centurytel.net G <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is c �� <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and o <br /> @BurnettCountyWLgov o --‘t. <br /> 0 <br /> Legal Description of Property:Lot 1 CSM#1852 V 10 p 87 and Pcl in GL 7 Desc 490/48 a ./, <br /> Section#:7 Town#:40 N Range#: 15 W Town of:Jackson v <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* G c <br /> Tax ID#(1-5 digit number;found on tax statement):5112 ,.., <br /> Proposed Use of Structure/Addition: Bathroom <br /> Anticipated Start Date:May 2023 (Home/Cabin;Commercial Business:Bedroom;Deck;etc.) CP <br /> Building Contractor:Northland Builders Inc Sewer Installer: NA 0 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMM)�NTS/CONDITIONS ONLY <br /> O <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: _ <br /> 064 r1teP -6,L( r 5 SeP);c. -v,,41/1 w0.5 onab/-c fv k /Ocedeol, O.\ <br /> + 014.6-1- ✓ncef 5 Se N-!717 D200^elt 3 kic-1- 49 Gxcee a bed,'"' Ft( <br /> Fee Rec: -Se-) <br /> 6 Check#:aa3g0 <br /> r <br /> rn <br /> Date of staff site visit: iaa Initi s of sit visit staff:g <br /> xi r- <br /> �� / ya ifill <br /> n <br /> APPROVED BY LAND SERVICES OFFICIAL: - %C DATE: Li1/0h 3 . u co <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o gi= o Effil <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT N <br /> Page 1 of 5 w nM <br /> Burnett County, WI Land Use Application—Rev 12/2022 d .. J <br /> 1 <br />