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• <br /> LAND USE PERMIT APPLICATION —Burnett County, WI a <br /> i <br /> Applicant Complete All Sections Below This Line 0• w <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> C7 <br /> w <br /> Dwelling/Principal Structure $300 • Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ..... 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0 j5N <br /> n <br /> ri <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 $500 cn \ <br /> p <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 I). <br /> w <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. . <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. i,fi <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r. • <br /> z <br /> Property Owner's Name: _A c/A _7 7,4eG") o �, <br /> o <br /> a. <br /> Property Owner's Mailing Address: 3o 52 / /elf` t."!Q Rv ,Gt// n <br /> City Mi ate Zip <br /> Property Site Address:3052/ ,,7 p/e.' 1.A4 .el/ L)f..'B''7/64.//5 .53( 3d o y <br /> • <br /> Contact's Telephone Number: 743-'/S/2-07z0 sD a <br /> 0 <br /> Contact's Email: $ZP/7// 4M/e . C /4/.1 `% <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and .. °q <br /> @BurnettCountyWl.gov o w <br /> d <br /> Legal Description of Property: L At r'S'L! . .7 97 0/'1.5T8 4. 0(1 <br /> Section#:,-q Town#: 00 N Range#: /cr. W Town of: SU/55 c, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement): L J¶� <br /> H _ <br /> Proposed Use of Structure/Addition: 0.09e FZ <br /> Anticipated Start Date:rifliG _fS (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ( �, <br /> De -O72Zv0 77�/ A'_4 - 67z.26o$Z9 • , �J 1 <br /> Building Contractor:���ti/tf/' ./ g/GL��S Sewer Installer: CO <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> @ MeCir- q,1 S e-`&Clt-5 C.3,. <br /> ia)okm5 <br /> couveii,_ lam+ 4 /40,c Se 14b r'r � <br /> i..41.04 ;5 o pi ('{�'''? <br /> 3 ,t/), l e(/cc g Fee Rec:l) � `t� pc,/1CS - 1/11; r/CL4 . 4 Check#:-7 qFd <br /> trf <br /> e <br /> rn <br /> Date of staff site visit: �� �� iti is si vi ' staff: u� < �=C <br /> n, (- <br /> APPROVED u <br /> BY LAND SERVICES OFFICIAL: 7( DATE: l0`� 3 .3 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o 0 w <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o <br /> Page 1 of 5 <--> <br /> Burnett County, WI Land Use Application-Rev 5/2023 u G <br />