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LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line ° c w <br /> n.Permit Types and Fees:(Please,check appropriate boxes) O VI l <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 W <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> •'1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> C) \� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 << <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500iii <br /> k\ <br /> cr <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 /> b <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. o <br /> 0 <br /> Property Owner's Name: Andrew and Emily Zaccardi o — .-..„, <br /> 5463 Erickson Road Mounds View MN 55112 <br /> Property Owner's Mailing Address: 1 n <br /> .41S City State Zip LA <br /> Property Site Address: anbury,WI 54830 lots and 2(request for lot 1) o <br /> • <br /> Contact's Telephone Number:651-675-7480 • o n <br /> Contact's Email:zaccardia@gmail.com 0 <br /> k' i <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N •o <br /> legible and your email provider will accept emails from the following addresses:@BurnettCounty.org and = 00 <br /> @BurnettCountyWl.gov - 1 Csv 5 a-7l vo 130 P 74 R�. 4s. 1,c 4.4 8/.i 9 F. N-1 <br /> Legal Description of Property: <br /> Section#:28 Town#:41 N Range#: 16 W Town of:Swiss p <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number;found on tax statement):22O 3 b5i f <br /> , <br /> Proposed Use of Structure/Addition: Single Family home <br /> Anticipated Start Date:o8t25t23 (Home/Cabin;Commercial Business;Bedroom:Deck;etc.) <br /> C—, <br /> Building Contractor: Owner Builder Sewer Installer: Taylor Excavating V) - <br /> z —0 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Po <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> by1ee-4- ill ?Ths <br /> ®v 1t& 'ici- 4 e ecL 1 .be/.'1 <br /> OimeI1f 4 44a be Soon �`I or k�er � Fee Rec: �42 <br /> �- <br /> 91 ecA_ J 1 z., ✓,,,b,./ ii f wafer o Check#: /lj3 <br /> 0 ieS5 dr, be l% --jz� 0/ a m 3 rn <br /> Itv <br /> un <br /> ` <br /> Date of staff site visit: /15I 9-3 'tial of site it staff: < <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: Bllaa 3 y <br /> C C 0 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z -- c--; <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Pagelof5 < �' <br /> Burnett County, WI Land Use Application—Rev 5/2023 v 3 <br /> J <br /> 1 <br />