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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> . <br /> Applicant Complete All Sections Below This Line 0 cn w <br /> Permit Types and Fees(Please,check appropriate boxes) ° <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 a <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ O <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 N..1 1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< t <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 g' W 0 <br /> Filling/Grading $150 Boathouse $500 <br /> co <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 -St', 5 ? <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. 'J\ <br /> f <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. � 11 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g I. <br /> z <br /> 0 <br /> Property Owner's Name: 5 yO w n Casm%3 y �Y�.s+ .Ti W <br /> ,,�t a. <br /> Property Owner's Mailing Address: (pa,g9) i?)6 W, i:(0 01'1 MC E .1 4 9 w. <br /> f] \ <br /> n - " City State Zip X <br /> I <br /> Property Site Address: 3 PO ate '"�� )r• �0.YlbILY1 , 5i'�'C 3b o y <br /> Contact's Telephone Number: 501 2.5O- 4'aq? "1---, 2. "i' <br /> Contact's Email: ( k-bYQWYl2A YYyi \ • (..0 m 0**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 5 °Q <br /> @BurnettCountyWl.gov v°o ,` <br /> Legal Description of Property: Lh J CS ' v IV T tgto (" NeN, Cy DV L(AS 't' ° 6 9.. <br /> Section#: 21 Town#: y-I N Range#: YY W Town of: SW►5S <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system properly page.* 13 r <br /> Tax ID#(1-5 digit number;found on tax statement): o� 1 (p1 b <br /> y <br /> Proposed Use of Structure/Addition: GaraRea.. Ye,-bc.61 ci <br /> Anticipated Start Date: A S U. <br /> U,. I.I,St' 2-OZ,3 U (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ' <br /> Building Contractor: -p Sewer Installer: Nl 1A- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Po <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 10tee+ ctII Seb4 , J\ <br /> �� . ,�A,4 is b1 -K�gtvvd-- <br /> 40 .4 „Lif65 b 12 /1/a3 x Fee Rec:` CA) <br /> y <br /> o <br /> Check#: <br /> m <br /> z <br /> i v <br /> 2 / / m <br /> Date of staff site visit: 7f 1J/ �3 nitials of sit isi taff: 1/ -=)^`'Jj <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 7/17/2 ? CA y CI. <br /> C— <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o gmc. <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT m <br /> Pagelof5nil <br /> Burnett County, WI Land Use Application-Rev 3/2023 v ;- �` J) <br />