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LAND USE PERMIT APPLICATION —Burnett County, WI ro <br /> i rd <br /> � <br /> Applicant Complete All Sections Below This Line t r Nti <br /> CD W <br /> Permit Types and Fees(Please,check appropriate boxes) r <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 o <br /> Commercial/Industrial Structure $300 ' Addition/Alteration to Commercial/Industrial Structure $200 ,. w o <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 p,� <br /> VI <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 •• <br /> (�'�� <br /> n V'/Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250o <br /> t/ Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> I./Filling/Grading $150 Boathouse <br /> $500 w <br /> o <br /> Solar Panels(Stand alone or roof mounted) $150- Permit Extension(1 Year Extension-Allowed Once) $100 o <br /> 'NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. 4 <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. c <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. S .! <br /> z <br /> Property Owner's Name: o <br /> �) 8 P <br /> Property Owner's Mailing Address: —74i 0 CcAh41L Rcl e .i'i(1j Sjr rvH 7�/ 5q 7,. n <br /> Property Site Address: (p5 2/ J�1///s � �� /, teltev/ City �9/yqs t Zip < y <br /> Contact's Telephone Number: '71 S-3./q- a/5- 7 /�� �`� 01 c <br /> C <br /> Contact's Email: Stann,+61tre td.i-)Av- t Ail cvi,(^'� <br /> **If staff has a question about this application,you will be contacted vi email. ake sure your email address is N •o <br /> legible and your email provider will accept emails from the following addresses:@BurnettCounty.org and 0 O° <br /> @BurnettCountyWl.gov <br /> in <br /> Legal Description of Property: �/.(a s1?%f a/ cI i'v ii. $ ,I 3. <br /> Section#:2 own#: 40 N Range#: /l0 W Town of: OakIci,i (yr ^ <br /> in <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tar system property page.* J: <br /> Tax ID#(1-5 digit number;found on tax statement): /3 5137 /3tr C 5 y 0 ER, C <br /> Proposed Use of Structure/Addition: l�t(*a,hii--Ci? ILA/f I`�ki /0/ 1Qr �i a(re.0 \ d ho <br /> Anticipated Start Date: !I/ // 9t3 J (Home/Cabin; ommercial Biness;Bedroom;Deck;etc.) <br /> / ". <br /> Building Contractor:Mt� � ��5�(A(�/�n, Sewer Installer: /� /�- `4'• <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z NAM <br /> �,�1 THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: - <br /> 0 Make. $ UI 74 peg ab y o7 'i(P ,t/'ln�//% 15e 4$ d7�je a e4/c/'es a <br /> Llat tre�'Nlt /Gt e- '1 . 1 / / �q <br /> TD//aw a// eras/r0dl GMNAi'I 12lbC�/GPf Cl $ re,pull .i/ g FeeRec: <br /> emy/h e-e-r, 6 Check#: ." <br /> m Na -ra,e P— <br /> Q a �J <br /> Date of staff site visit: / Z/ I also site v' ' staff: y'//' 1 <br /> APPROVED BY LAND SERVICES OFFICIAL: �-"'— DATE: 05/°-te3 11) <br /> M <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF $, z m ©? <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT y Guy <br /> Do . <br /> Pagelof5 `:43 3 NJ <br /> Burnett County, WI Land Use Application —Rev 5/2023 = 3 w <br /> RI <br />