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LAND USE PERMIT APPLICATION—Burnett County, WI ro r <br /> z c <br /> Applicant Complete Al!Sections Below This Line c' v ct; <br /> c,. ' <br /> Permit Types and Fees:(Please,check appropriate boxes) d "C <br /> , <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 . <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 )C.) c <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> c <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 .c 13 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ro w <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 _ Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. `< <br /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. rc <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g., ,J. c <br /> Property Owner's Name: ! v Q Ski f(,(/1 > -a,_-r t o .f--- o <br /> e <br /> Property Owner's Mailing Address: c' {________n <br /> cA <br /> a g S4 - 4 'covis.& W' SSt' Zv/Property Site Address: o�� � t- ��/_ ��// o <br /> Contact's Telephone Number: ( 7 S$ i 483 H <br /> . <br /> Contact's Email: I I t G(M S+v,tdian <br /> **If staff has,a question about this application,you will he con ted 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 z °O <br /> @BurnettCountyWI.gov v <br /> SE S E Ex CSnV V13 PI 8 N <br /> Legal Description of Property: y�� <br /> Section#: ' 3 Town#: 3 q N Range#: I ! W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* W s <br /> ( Ito 37 / 63�g `',' "„ ° <br /> Tax ID# 1-5 digit number; found on tax statement <br /> Proposed Use of Structure/Addition: Cjr.l't ei)G 11)C.45 rc.1c). <br /> Antici ated Start Date: C�1 <br /> p IHome Cahin:Comorerrivl Bxsiness;Bedroom:De••,,etc.)Bui!ding Contractor: N lA- Saver Installer: l0 <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 7, <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> No+ cc{ hu.►nu,„,, 1 ,b( _ <br /> Fee Rec. 3OO <br /> Ez <br /> Check#: L/ 7(D <br /> 7. <br /> z <br /> 0 ' ^ <br /> cA <br /> Date of staff site visit: liV/20Z3 Initi s of site visi staff: 7l ��/�' <br /> t SERVICES /ii/ ZVirg <br /> APPRU�ED BY LAND UFFICI '• cri T CD ,..4. Q M <br /> Pagel of Z vo <br /> Burnett County, WI Land Use Application —Rev 5/2023 LI 7 <br /> m '� �:, <br /> r... J wU uU <br /> r. <br /> < 7 <br /> LL JJ <br />