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y LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 0 c w <br /> Permit Types and Fees(Please,check appropriate boxes) GCl.' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 •--..t O <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 c ° N <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 0 <br /> Filling/Grading $150 Boathouse $500 1'� <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 I <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. <br /> ro <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. CD 1 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g • Pb <br /> 4 <br /> •Property Owner's Name: i =' ' <br /> p rty T rv1 �i P n �t- - r�n bay `� o <br /> Property Owner's Mailing Address: �b uX j 55 -Duo u U- ` .5'100 1 n <br /> _ Cit J Z_ip k) i <br /> Property Site Address: 3.g 0 a I j K 1 i �f e 21 W e I(�S V" ntei IJ� c 3�� o yh. <br /> 1 lb <br /> Contact's Telephone Number: (;Q 12- L{ '3 4, �j 5�j a - <br /> Te <br /> Contact's Email: d.{ € d L21// S /Q 0 e 6 W I U I e NO <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ,ti <br /> legible and your email provider will accept emails from the following addresses: @BumettCounty.org and 010 <br /> @BumettCountyWl.gov w <br /> d <br /> Legal Description of Property: S ), /T - o/R I w Sgy t 1 C� h t &'�C►i C 0-f 3/ 5• <br /> Section#: a Town#: Lt 0 N Range#: ` ,)5 W Town of: tj(.t_C k.S 0/r) <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C_. b o <br /> Tax ID#(1-5 digit number; found on tax statement): V.3 Li I �-�(� <br /> im. <br /> Proposed Use of Structure/Addition: S t- ea <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) y C� V`� <br /> Building Contractor: Sewer Installer: k{vPY__iY's <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 1 i ie 4- a[L 5€ &cl( . I `� <br /> apkiol-- -6r u Vvtk n b/il-b " <br /> Fee Rec:1 ' <br /> o Check#: i <br /> m <br /> z <br /> We•-•• <br /> �0nDate of staff site visit: 7/10/73 i is of;te v s t staff: I`" j' `I i <br /> APPROVED BY LAND SERVICES OFFICIAL: I sir DATE: WIT/023 =� ��`8 g� <br /> ;,,, <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> A w <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page l of 5 v'' �U <br /> Burnett County, WI Land Use Application-Rev 3/2023 <br /> 4 <br />