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LAND USE PERMIT APPLICATION - Burnett County, WI a <br /> Applicant Complete All Sections Below This Line 0. c w <br /> Permit Types and Fees(Please,check appropriate boxes) V` <br /> _i Dwelling/Principal Structure $300 ( v Addition/Alteration to Dwelling/Principal Structure $200 P 0 <br /> ID <br /> Commercial/Industrial Structure $300 ( _ Addition/Alteration to Commercial/Industrial Structure $200 L', <br /> O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 r` <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 s <br /> o �+ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 II4 < V <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 ' o PO <br /> Ai <br /> Filling/Grading $150 Boathouse $500 11 <br /> VD <br /> 31, <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. _1 1 <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> i. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. S <br /> "� li o <br /> Property Owner's Name:, �hGrn/�LY7 Ct{�GI / J?)/' 9 0 <br /> Property Owner's Mailing Address:LI/S31. 61,---gridt..9/ad zy Ecim,Pf to `ffu <br /> 5' <br /> L ' •\n� City _ State Zip E <br /> Property Site Address _ Li I'1 C(})n 51 W J IrU,I } o y <br /> Contact's Telephone Number: (S/ -7 /5 o"]'t 3 ' ro <br /> N ,i d Nro ` <br /> Contact's Email: JaiSr 2q e .( /J 1 <br /> . (�� C <br /> **If staff has a question about this application,you will contacted via email. ake sure your email address is N b <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and °c 0° <br /> @BurnettCountyWl.gov (3,) <br /> 0. <br /> Legal Description of Property: Se rrt 5 / iS)D/ Lo jL 5 Goe-l�` 5 <br /> 2 L16 <br /> . <br /> Section#: 3 Town#: © N Range#: / W Town of: ('j a, ./c-et,c, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* &` o <br /> 1-3 <br /> Tax ID#(1-5 digit number;found on tax statement): / q 7 It <br /> N <br /> Proposed Use of Structure/Addition: L 1 V t ws nr-4-,-- <br /> Anticipated Start Date: (/Git r.4.• } C(r.„,it(Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ,,1� <br /> Building Contractor: Sewer Installer: �� `& ^ <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 /> (1 hied- q II 5eActci <br /> el l s ti(j nv4}- .0 eAeee.,4 a beetewems pc SO- /el/ I <br /> io)e ez k rh) e-i- 5 Vctr;9,4c e c'r r�e ,,,',,.:1 }o R <br /> r / (� /' Fee Rec:C !c <br /> ofe ti D y 61 J C be wi I4 a 1 4o 4 r 5442 <br /> Check#:W <br /> II m <br /> `j /2s Z3 / o ,,, <br /> Date of staff site visit: 7 iii23, 7h'7l7'3 'tial of sJ <br /> t staf < r <br /> APPROVED BY LAND SERVICES OFFICIAL:LJ'w DATE: l y cn co a�/�3 r- <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF zoo /ff <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT w <br /> Pagelof5 < ' ' '' 11 <br /> Burnett County, WI Land Use Application-Rev 3/2023 0 J <br /> -3 <br /> a <br /> 3 <br /> wv <br />