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LAND USE PERMIT APPLICATION — Burnett County, WI PI <br /> cr <br /> a i <br /> Applicant Complete All Sections Below This Line o c w <br /> pP p a I <br /> CI. <br /> Permit Types and Fees(Please,check appropriate boxes) d „_ <br /> Dwelling/Principal Structure $300 •Addition/Alteration to Dwelling/Principal Structure $200 a <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 .9 F4 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 g� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 ir <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 tothree times the normal fee. `' <br /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> o Property Owner's Name: o _ <br /> 0 <br /> Property Owner's Mailing Address: 6'2 9 I4)EST ill L'rg. plc l b y 0INnt Pub iv S 5 3/6 >v. n S <br /> City State Zip `" <br /> Property Site Address: 2.Z b L.Cj O t- © 3 r,�5 Dr .1,}J E Ls (A)] 14 54+A 7'7 a <br /> Contact's Telephone Number: 4D`'2 . I , S . (p 44 3 a' <br /> d \J <br /> Contact's Email: -�c7 -en U S -�- ,, E <br /> **If staff has a question about ilt 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: @BumettCounty.org and S `M <br /> @BurnettCountyWl.gov f <br /> ko d <br /> Legal Description of Property: }�l{'�' Q�''� I /2_ Si 51 ,3,� ( �(� r.� •71N� �'L 3. <br /> Section#: '2-3- Town#: S 3 N Range#: R 1 1-- W Town of: I)A P t E L „ Zta , <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ) H <br /> Tax ID#(1-5 digit number; found on tax statement): ' .692 3 <br /> Proposed Use of Structure/Addition: EAC 1C Po e c'.H I Dec L. <br /> Anticipated Start Date: c.\-U6 I 1 2_013 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) M <br /> Building Contractor: Sewer Installer: N 3 / J� `N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z V <br /> THIS PERMIT IS SUBJE T TO ALL CONDITIONS LISTED BELOW: <br /> 1Yleefr- all A ,..., <br /> c2,... <br /> n <br /> 1, Fee RIi o` <br /> o <br /> Check#: 5 <br /> m <br /> z <br /> �i rA <br /> v <br /> Date of staff site visit: (2/3 /P-3 Lh <br /> s site 'sit ff: V Slyla� m< �� <br /> APPROVED BY LAND SERVICES OFFICIAL: Q DATE: gg <br /> ® ? <br /> Q CV 0 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 14,0 <br /> N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT j 0 —Im, <br /> Page l of 5 < -' <br /> Burnett County, WI Land Use Application—Rev 3/2023 <br /> a <br /> z <br /> -e <br />