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LAND USE PERMIT APPLICATION - Burnett County, WI 7 <br /> IV <br /> Applicant Complete All Sections Below This Line 5 w <br /> Permit Types and Fees:(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 1 <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 \ g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ,-,'- <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 O <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r. <br /> -Fillii'eft°d►ng M Q Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 -4. <br /> w <br /> `NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. !i <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r <br /> z <br /> 0 <br /> Property Owner's Name: "1-140MAS A VII"1PH26V S 1V1/41 I b <br /> Property Owner's Mailing Address: Z9(43 L d G-Lit KE TV A I L—D1{i9 UQY WI 5V 3O J <br /> City State Zip '' <br /> Property Site Address: 2-9 C.07-3 L) �'L--A KETQ A I L ))14,j u(j (ALL5V( 30 < <br /> Contact's Telephone Number: LD 1 2_ -3 0 S ape° 2 <br /> Contact's Email: KO Q1/4-5f _l r,'i N ACTiONliI ..00ILt_ <br /> **If staff has a question about this application,you will be contacted 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 <br /> @BurnettCountyWl.gov rg. <br /> Legal Description of Property: (-or 3 (.SM V 2 P 2.59 'PCL &C*I LC 'T I-. <br /> Section#: Z Town#: 41 N Range#: I!p W Town of: SW I_SS s <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* N - .. <br /> Tax ID#(1-5 digit number; found on tax statement): 2.2245 <br /> Proposed Use of Structure/Addition: . 00.RABE .E 1-, <br /> Anticipated Start Date: t)ME IS 2,0Z3 (Home Cabin;Commercial Business;Bedroom;Deck;etc.) '•r.- <br /> Building Contractor: A�k r4 Sewer Installer: �A 1 V ' r - <br /> z V ► <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY x 1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> ( Meat a it 5e4buck5 <br /> 15,4h4 &r bN,r/A" h46, 1 4keel- rr <br /> Grp 5ti4 e� �. (artb `/ <br /> Y ���� • x Fee Rec: <br /> .1 � i <br /> air9ns c <br /> 5 Check#: (a3 <br /> KT <br /> a <br /> Date of staff site visit: W Iif22_� ti is site 'sit taff: <br /> r ,i <br /> 6 /2//r� E. <br /> UUQ <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF . - _n0 <br /> 1511 N ID ~ - <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o= N„ o <br /> Page lof_5 § w <br /> Burnett County, WI Land Use Application —Rev 3/2023 ,,� ' 1 lfl <br />