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• <br /> • • LAND USE PERMIT APPLICATION — Burnett County, WI a I. <br /> Applicant Complete All Sections Below This Line 0. w <br /> a <br /> Permit Types and Fees(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> o�' $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Commercial/Industrial Structur33eOp <br /> N <br /> Accessory Structure(Garage,Shed,etc.) Addition/Alteration to Accessory Structure $150 o <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 C <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 B <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. `' NW <br /> it <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. z _y <br /> • r <br /> Property Owner's Name: ci i,e f I J e f 7'�S 4 L.l' o <br /> . <br /> Property Owner's Mailing Address: w I <br /> L City 11State Zip ° E <br /> Property Site Address: i/y 7 L f s," k.,. RA Cp`art,Tj h u.f S, W I s'yf q <br /> o N <br /> Contact's Telephone Number: 7/Jam'_ '7 7 D 6.21 a R <br /> \, d <br /> Contact's Email: /4 thtotN,l 1O Ser-Jj > e.-O IAA-. co <br /> **If staff has a question about application,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and (0, °Q <br /> @BurnettCountyWI.gov 0q <br /> N A /Nu-S4-- 3 <br /> Legal Description of Property: �y / 0 <br /> Section#: 3J' y Town#: 3 / N Range#: /7 <br /> W Town of: WeS/ t/Q'sA/"1Y c, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.*2 W F H <br /> V10Tax ID#(1-5 digit number;found on tax statement): , �C . <br /> ct <br /> Proposed Use of Structure/Addition: /44 6 y /Sfera y e ` <br /> Anticipated Start Date: (Home/Cabi/ Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 0 pot- 7"v be, use-4/ - ‘N AN t~ngv` t gb/I-Si,A . <br /> z Fee Rec:3Ce,q-' <br /> v Check#:3.2 <br /> m <br /> o LJ <br /> r <br /> �J <br /> Date of staff site visit: RV���Zia Initials o site v" • taff: T'! < a [jji. <br /> APPROVED BY LAND S ICES OFFICIAL: / DATE: 0-8/F-4,2-'3 6 2 ` 1:1 0 <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF z at m 0 -.- <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT w <br /> Pagelof5 < �' <br /> Burnett County, WI Land Use Application—Rev 12/2022 o I J..) <br /> a <br /> 3 <br />