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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line CD w <br /> Permit Types and FeesIPlease,check appropriate boxes) Cl. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <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 i <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 g <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 P <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 , <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <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. ' n' VA <br /> g M <br /> Property Owner's Name:_ n �o .-az-'u-L �( r, o — i <br /> Property Owner's Mailing Address:-7--%2 6-3 >0,-�l ►T``-rde.,'-N 1 r n�,��,'0' IA/1 5 ' I. <br /> 1 ' i 1 City State Zip z <br /> Property Site Address: <br /> Contact's Telephone Number: D� _ 7 �`��)�� <� <br /> - d <br /> Contact's Email: i<�'"t ov\4.ecu v C�X a L C-0,'2-1 <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is b <br /> legible and your email provider will accept emails from the following addresses: @BumettCounty.org and °aV w <br /> @BumettCountyWI.gov o t7 ` <br /> fn" <br /> Legal Description of Property:� A.sING(\tr.,K �. <br /> Section#: 3z- Town#: `>d Q N Range#: / ? W Town of:C, � 6�' X._ v. N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* t . 5 <br /> Tax ID#(1-5 digit number; found on tax statement): IL f 4 �+— <br /> � <br /> Proposed Use of Structure/ ddition: P�G.K <br /> Anticipated Start Date: $A n (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) — <br /> r <br /> n I <br /> Building Contractor: !a r V <br /> 60fi-"f G-( ,et 3Sewer Installer: <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY xJ <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: �-- <br /> Y I ✓ -eC-)—,9„ II 5efb c,JtS <br /> Owe II' / -� eXc becl vooili s per 56e 4- 6 l i 7 <br /> s Fee Rec: o ) <br /> v Check#:55 Veil- <br /> m <br /> z <br /> z <br /> f?3 rr <br /> Date of staff site visit: 0 I ' ials f site vis' staff: < l <br /> 5//0(23 tr� 'IM <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: ci) D <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF T g( ,� �' <br /> "cn p p N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT . cc <br /> Page l of 5 <br /> Burnett County, WI Land Use Application—Rev 3/2023 U ( J <br /> i <br />