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LAND USE PERMIT APPLICATION — Burnett County, WI r <br /> i <br /> _ Applicant Complete All Sections Below This Line o' c 67, w <br /> CD I <br /> Permit Types and Fees(Please,check appropriate boxes) ° (, <br /> d <br /> ' Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 cp •.1 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 �� <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 A 1 <br /> `ti° <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < <br /> .. t 4 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 E. <br /> Filling/Grading $150 Boathouse $500 <br /> v) <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E. t <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. CD <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. -• <br /> Iko Property Owner's Name: 1-1.,no,r,-s C.O.0 i 42' o 1 <br /> a. <br /> z ,� <br /> Property Owner's Mailing Address: S Z''' cAc,relc'. I4 $eu v S—tio j( d. <br /> Zg12$3 f I y State Zip ° E <br /> Property Site Address: j/1 c./c�c.!c,r—lii LIc'-{i,�._ i r Ga {' 13e `' ►�t°'C tr �I✓ i'.-- N c <br /> Contact's Telephone Number: 6.:S1 S 3 &—c't 77 n. <br /> d <br /> Contact's Email: k\-C i'i i -S (..1)(-',I 1 e L r►'l.c.Li L : LC Let. <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N Pt' <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and 0 w r.o <br /> @BurnettCountyWl.gov a <br /> d N <br /> Legal Description of Property: S e-t— C`'►-Lt.-Lt. c 0.- OD _ - �^ 6. W <br /> Section#: 13 Town#: 0 N Range#: 1 S W Town of: `l 0,J-S-ty1 ~ <br /> �7 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* o H <br /> d <br /> Tax ID#(1-5 digit number;found on tax statement): I3S C% w ) d <br /> Proposed Use of Structure/Addition: i c;... (c_. Fk-p„ <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) SI <br /> O <br /> Building Contractor: t11,;;..tu-4-./.e/1 e �y.,c,,r-- Sewer Installer:75S ToI landeK <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: _ <br /> • /44' a u Se,-Fbc S CA <br /> ' tvdtl.iken &Sir M.u.s-E- be okfpru,tst IN U.Dc, a1ct Vo`{ay..,- Viacici--- <br /> • DIr�1�,� J f"'ht+ [�€)Cit-Lck 3 A.feltspa1S Fey" S -23 - 141 0Fee Rec:T' 1 <br /> o Check#: 5 <br /> rr <br /> l _J <br /> z <br /> �j— rito <br /> Dv <br /> Date of staff site visit: 'I i j/z013 Initials of site visit staff: N 1 cono c a u <br /> APPROVED BY LAND SERVICES OFFICIAL'y��/IXMN) DATE: f ZI/ZpZ3 gg 3 r <br /> :p (.3t N <br /> ' C) Ca i <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF I ,§ 1 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page l of 5 1)-) <br /> Burnett County, WI Land Use Application-Rev 3/2023 v <br /> c. <br /> i <br />