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LAND USE PERMIT APPLICATION — Burnett County, WI c r <br /> . <br /> Applicant Complete All Sections Below This Line o w <br /> Permit Types and Fees:(Please,check appropriate boxes) a dj <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 \- `0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 .� <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ,- it <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> • <br /> Filling/Grading $150 Boathouse $500 lib <br /> iw <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 R. <br /> w <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. ' <br /> ro <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. pp <br /> o <br /> Property Owner's Name: V 1 kc-ita el 6 6-6 Crn,ci y Z.n(,, vvi 4-47 o W <br /> - I <br /> Property Owner's Mailing Address: 2 4/S f 6 eG.,>e,1 G•i R 0(.4,1 (,J e--6 4-ef* LOP- St7dl3 '7. n lb <br /> City State Zip E <br /> Property Site Address:27LiS f Gn..0au; i c.-L IA-14Sder VJ2 .5-"ref"f 3 o y op <br /> Contact's Telephone Number: 7/ S-SS0 3 3- // °CD <br /> **If staff <br /> C)-i�L. 1,y , N4.6 G. <br /> 3k/ 6 ,qN'1Gcd! • Con, 6 �V <br /> If staff has a question abdut this appli ation,you will be c tacted 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 - °Q CP <br /> @BumettCountyWl.gov cio vJ <br /> Legal Description of Property:ter <br /> I ( tvi ' !74it V?6 9.3)7 (5w Nr } 050045P9? I <br /> 0 V <br /> Section#: 3c. Town#: LehN Range#: I Co W Town of: Dee.YtGe,‘a/ w <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* Q <br /> Tax ID#(1-5 digit number; found on tax statement): 3 (€:,( <br /> GW <br /> Proposed Use of Structure/Addition: SCrr{G,- PO -. ^r- <br /> Anticipated Start Date: S CV (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) t # -� <br /> a--. <br /> Building Contractor: 64l e Gji►dj.... L}.;on Sewer Installer: 11/4 <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY L:, <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 6) thee-1- j I 56 GS 5043 I a l l <br /> . ellt 4v e ceJ3, b � e <br /> give-v <br /> SS 511 t5 ne-e-d 9.02'q s Fee Rec:ox <br /> c Check#: (e$ <br /> m <br /> o ' t-7 � <br /> q I m r- �—�=J <br /> Date of staff site visit:5I ! P3 Initia s of sit visit staff: '1 < gInnl <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:5 /0(?- rn I <br /> m D 0 <br /> a 5 m Ind <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF zoo f- Uoll <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT , 2z w <br /> Page 1 of 5 <br /> Burnett County,WI Land Use Application—Rev 3/2023 0 .J <br /> a <br /> i <br />