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LAND USE PERMIT APPLICATION — Burnett County, WI C <br /> a <br /> . ►b <br /> Applicant Complete All Sections Below This Line 0 � w <br /> Permit Types and Fees(Please,check appropriate boxes) <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 S LY1 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 _\ O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 V po <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0 <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 _ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 to- <br /> Filling/Grading $150 Boathouse $500 cn <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 1. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. <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. S z Q <br /> 0 <br /> Property Owner's Name: r cS o to vh G t ) o <br /> 0 <br /> Property Owner's Mailing Address: ?7 D 3 6 1 S e g d 14h 6 Ste c W, _s Vg 3( n , <br /> City State Zip E II <br /> Property Site Address: Sa WI e C <br /> � o ti <br /> g <br /> Contact's Telephone Number: G 0 - 3 3 y- 56, y Q. <br /> d <br /> Contact's Email: Cc 1.1pu en a .v Of /r, S rv, C a it <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following addresses: @BumettCounty.org and V °Q <br /> @BumettCountyWl.gov ag <br /> C7 <br /> ^} • <br /> Legal Description of Property: t4 W/`/ 0 ' se a t f 6 41 NC 6 ( 3 <br /> Section#: r 1 Town#: 3 9 N Range#: i 7 W Town of: L.;A CO.I 1 <br /> .v CA <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* c <br /> Tax ID#(1-5 digit number; found on tax statement): 10$0 y W <br /> -3 .! . <br /> Proposed Use of Structure/Addition: 0 e L.k cj <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) t 1- <br /> Building Contractor: S't lc 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 /> M Pe+ a J( Sc &.cram-S <br /> Fee Rec: /o25 <br /> o Check#: /7/ <br /> m <br /> z <br /> z <br /> o <br /> Date of staff site visit: 514/a3 Initial of site isit staff: x r <br /> w <br /> iS t11J <br /> ����••--// y a 3 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:58b-3 a W x n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z o G <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT , I — <br /> w Q <br /> Page l of 5 3 nM <br /> Burnett County, WI Land Use Application—Rev 3/2023 v �� <br /> -a <br /> a <br />