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LAND USE PERMIT APPLICATION — Burnett County, WI <br /> o <br /> N <br /> Applicant Complete All Sections Below This Line w <br /> Permit Types and Fees:(Please,check appropriate boxes) i Y d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ---. --, <br /> XAccessory Structure(Garage,Shed,etc.) C $15 Addition/Alteration to Accessory Structure , $150 g. <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 G� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 », <br /> r � <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 LS <br /> Filling/Grading $150 Boathouse 50 1 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 ' <br /> m <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. `� <br /> -c <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. u o ii <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ^ <br /> o <br /> Property Owner's Name: p [ , N Cl n <br /> Property Owner's Mailing Address: �Cg� S CA I �',)t - (tY` ) 5 Z r) <br /> C,, I j� City/ State Zip cn <br /> . Property Site Address: C (b7 �ZA� hoirdil'"t La-(ire. frejerk ) CAD( 237 a.. o <br /> • <br /> Contact's Telephone Number: <br /> �7 ) 5 32 1 - 1i 1 • <br /> 0 <br /> 3 -� Iola ci- �4, � 9mai, ,(on'1 <br /> Contact's Email C1�'S r <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 /> @BurnettCounty W I.gov °0 <br /> Legal Description of Property: Ls4}i Z.. 7F ce.&E. L U, L-..± 110 �` <br /> nn <br /> F. <br /> Section#: 2-I Town#: '3"1 N Range#: K i S W Town of:7 L LAC v) <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o ii <br /> 9%3 x <br /> Tax ID#(1-5 digit number;found on tax statement): 24 3?I'f <br /> Proposed Use of Structure/Ad ition: St`o"a er e, -_ <br /> Anticipated Start Date: '7 � 3 J 2.3 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) V4 WM <br /> ,� W <br /> Building Contractor: Art.osice.�,n eel lneSewer Installer: NSA 1 --r--_ <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: _ <br /> efileci_f.,aii Se-i-bk. i- N,Ndi, ( Au, ' kb ' <br /> C. L - y eeA Ariikes.s b 1.//1?.3 <br /> /y ? Fcc Rec: <br /> v d Check#: : 7 <br /> m <br /> m <br /> a <br /> d L J <br /> m r- <br /> Date of staff site visit: 7/27/d 3 iti s of si vi t staff: < a> <br /> 0 <br /> APPROVED BY LAND SERVICES OFFICIAL: ,i DATE: 7[31) 23 W c 0 <br /> Page I of7 $ o0 — o <br /> Burnett County, WI Land Use Application—Rev 5/2023 `- v N cC <br /> Aw Innf <br /> ` lluU <br /> m ~ L JJ <br />