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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> s c <br /> ;o <br /> �' r N <br /> Applicant Complete All Sections Below This Line to.) <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 m 00 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 <br /> VAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 RT <br /> Q <br /> 1111 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °_ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 r <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E <br /> i; <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> r E <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> Property Owner's Name: 0cM011 1Z +� o <br /> o <br /> Property Owner's Mailing Address: 2.0'1t1 (_ou y +mil Y Ur,,I►TS&r , CW/0 ' n <br /> AA City Mate Zip <br /> Property Site Address: SWIG 46 440"e o v <br /> Contact's Telephone Number: 71S' S'c'{- 33fsy _a <br /> C <br /> Contact's Email: Damon R 1.774 1'14+1. °'' <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N - <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and ° cr. <br /> E. <br /> @BurnettCountyWl.gov <br /> CC Q o <br /> 5 <br /> Legal Description of Property: 3 W soy - T37N- '`asw' <br /> Section#: 09 Town#: 37 N Range#: l if W Town of: Tr +e, t kc <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o ' <br /> Tax ID#(1-5 digit number;found on tax statement): a 3 2" ,C 4 a <br /> Proposed Use of Structure/Additi n: <br /> ci <br /> Anticipated Start Date: 7f(o 202.3 (Home/Cabin:Commercial Business:Bedroom:Deck:etc.) W�� <br /> ! <br /> Building Contractor: !V/if Sewer Installer: N//� <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z: <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 64- ,co( Mao kftb,-6-t0 <br /> Fee Rec: /50' <br /> 7 <br /> o Check#: c2(06 <br /> m <br /> r <br /> cn <br /> Date of staff site visit:51*3 Initials f site vi 't staff: P < z <br /> • <br /> APPROVED BY LAND SERVICES OFFICIAL: nATE:S/3 3 - <br /> n � <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o 0 0 0 13 41 U <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT m: P N c< <br /> 3 <br /> ril <br /> Page l of 5 <br /> rn <br /> Burnett County, WI Land Use Application—Rev 3/2023 0 Lam) <br /> a <br /> 4 <br /> -0 <br />