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LAND USE PERMIT APPLICATION —Burnett County, WI 1 E <br /> g b <br /> • tJ <br /> Applicant Complete All Sections Below This Line 5' fQ• W <br /> C. <br /> Permit Types and Fees:IPlease,check appropriate boxes) C <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 Et <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 U 0 <br /> / E <br /> V <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 • <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < • <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 t— <br /> o <br /> Filling/Grading $150 Boathouse $500 <br /> cn <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 , 56 <br /> 'NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. <br /> 0 <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. " <br /> Property Owner's Name: . , ( ,Pr l LI <br /> Property Owner's Mailing Address: at t 1- tO t t"tf gt_ 1 up tC 9Td 7 <br /> City State Zip X <br /> Property Site Address: SC--t^"-)2_.. . < I <br /> r J. <br /> Contact's Telephone Number:_ I (4l'`t -24 r- ' <br /> Contact's Email: j/--G 1sjj 6,lt tkAffiNe e.A.0 ►3Skt p . CO Nl <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ,y <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and I E. °° ` , <br /> t BurnettCountyWI.gov o, <br /> c. <br /> P1/4 Legal Description of Property: 6 2..._._ ( .L .AJLJ /J V daq Pam.v ..P 3 ec4. i <br /> Section#: t k_ Town#: 70 l N Range#: [ g W Town of:f l4,A.e L <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> 22 (•— = E3 <br /> Tax ID#(1-5 digit number:found on t x statement): a-7 qt 3 i .—\ <br /> r_ 4 --1 p <br /> Proposed Use of Structure/Addition: t.- _k —\Q�� w C- <br /> Anticipated Start Date: hd�__20Z; (Home/Cabin;Commercial Business;Bedroom:Deck;etc.) <br /> Building Contractor: LO-!'r+\ N1/41-frItliftlitd10e.raid7 Sewer Installer: A) _ 1...... A) <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/C NDITIONS ONLY If:.), i. <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 0 Mee,-(—' a l( $e-4- Gks (kQ <br /> 0 NF ,n4G6'nr F Lai bt t S cI//owe / <br /> g1,�� to < <!a 3 <br /> la k t d 1e1i4 /s aeecW On $e7 -f rt4 i Fee Rec. � Q� <br /> CO tiOvJ A 11 �4d�o✓ls D't cuP "a! - j Check#: ii_(�3� <br /> rr <br /> - <br /> z <br /> I v <br /> Date of staff site visit: 6 i!31�3 I i 'als t f site isit taff: 71u r ��'J�' <br /> APPROVED BY LAND SERVICES OFFICIAL: ,I �l1 qla <br /> t DATE: COV. co n <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF w <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT x D= o 0 <br /> m N <br /> Page l of 5 < 2 hal <br /> Burnett County,WI Land Use Application—Rev 3/2023 0 W -0 <br /> x <br />