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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> s <br /> Applicant Complete All Sections Below This Line o' w <br /> n. <br /> Permit Types and Fees:(Please,check appropriate boxes) l(' (if, " d <br /> w Q <br /> Dwelling/Principal Structure $300 .}4 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 .� O <br /> ` ~ <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 &j <br /> P O <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o W <br /> Filling/Grading $150 Boathouse $500 1 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 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. 0 b <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g' ; <br /> Property Owner's Name: L.CLIA.1'i I hi.(,l,cn t(.-aLCreen_ ) " o <br /> Property Owner's Mailing Address: 1� �i V�1 C t L_t.t V 1 1 `"0 7 n <br /> Property Site Address: p'�-5 LO Li) 6A--5 ��% vL (i t tdib5i int. ULM S � <br /> g <br /> Contact's Telephone Number: &Ic - g '4- � g a <br /> L 7 ii(kJ ze.n el (pm<a51-•()Li- <br /> Contact's Email: CD <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 r °O <br /> @BurnettCountyWl.gov <br /> cj.vtle La <br /> Legal Description of Property: <br /> Section#: 3 Town#: 3 y N Range#: 1 Co W Town of: ,e-Cf2Q il <br /> .75 �, <br /> *Attach additional page if needed for lengthy description OR attach a copy o the deed OR attach tax system property page.* n <br /> Tax ID#(1-5 digit number;found on tax statement : 1 17 <br /> rr <br /> Proposed Use of Structure/Addition: ,1"ee/l OrCb1 J <br /> Anticipated Start Date: ( me/Cabin;Commercial Business;Bedroom;Deck;etc.) `VJ p t1 <br /> Building Contractor: Sewer Installer: V <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJCT TO ALL CONDITIONS LISTED BELOW: _ <br /> ff01 eeit" tiU se4ick 14-- <br /> wi- +0 ;n crecse # 4 i)eetmciv <br /> x Fee Rec: c2CID'- <br /> v Check#: I Q <br /> m <br /> z <br /> rn <br /> Date of staff site visit: / 3 I a 3 I it'al of s' a v' it staff: )ler- <br /> < ��-� <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 7023 M E. 4.— <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o m o ((''��° <br /> v0 1' <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT . CD K 2 <br /> Page l of 5 < co �] <br /> Burnett County, WI Land Use Application—Rev 3/2023 0 �` , <br /> a <br /> 3 <br />