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CID .0 <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> i b <br /> cn Applicant Complete All Sections Below This Line 5 w <br /> a <br /> Permit Types and Fees(Please,check appropriate boxes) C7 <br /> (Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 . <br /> "Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 4.--- p <br /> }( \ g <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 �, <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 G,- <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °" <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 .i , <br /> ` <br /> ,„ <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. <br /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. CD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. " <br /> 0 _ o <br /> Property Owner's Name: kc.,L,,e,t'1— /4 G y, s‹,rj c N <br /> Q. <br /> Property Owner's Mailing Address: ---/S 6 0 G-/r,il J.,r ;01 Rc{ IVc vi�..i L/) s`f�k: n I <br /> _ City Sta Zip ° "' <br /> Property Site Address: DA YY` o <br /> Contact's Telephone Number: -7 ) Si S 2- c1- t-/92 7 T> a <br /> (` a <br /> o <br /> Contact's Email: to — — 10 !ici Yisc'►0 Q. lj,, 1 > c't c_c <br /> �. .)>n `% <br /> **If staff has a question about this 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 =. <br /> @BurnettCountyWI.gov ct 0 <br /> ^� ,n o P <br /> Legal Description of Property: L oT Z V 2 7 P -. 3 Z_ =. <br /> Section#: O S Town#: O N Range#: /-t‘ W Town of: Qc k 1 c,),,c/ co <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o <br /> o C7 <br /> Tax ID#(1-5 digit number; found on tax statement): 3 5'3/3 <br /> Proposed Use of Structure/Addition: 5/1-c_t <br /> Anticipated Start Date: - —} � <br /> /-- 2 ,2 j (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) CT` _1 <br /> Building Contractor: Se./(— Sewer Installer: A/6/ W <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: r._ <br /> Qfl1ee-- 411 54DeJts ts- <br /> C; 104. human 44b.:kkollao <br /> Fee Rec:15) 11 <br /> e <br /> Check#: 37 <br /> ni <br /> Date of staff site visit: 6 /‘ (a3 it'a of s' v' it staff: <br /> MI <br /> APPROVED BY LAND SERVICES OFFICIAL: � 1 DATE: t�/772 t. co <br /> 3 -< C) <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF El <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT '0. w C <br /> Page l of 5 <br /> Burnett County, WI Land Use Application—Rev 3/2023 <br /> 3 <br /> -o <br />