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LAND USE PERMIT APPLICATION -Burnett County, WI a <br /> . b <br /> Applicant Complete All Sections Below This Line a w <br /> Permit Types and Fees:(P/ease,check appropriate boxes) <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 "Xl O <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <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 <br /> a <br /> (Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 o. <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. 9 C <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. F <br /> z <br /> 0 <br /> Property Owner's Name: Bak h 1el c u.5ek w t3r'u kk 1Nn Y.S 4" o ,_I W <br /> o a <br /> az- <br /> Property Owner's Mailing Address: /Z I i E ,h i C., i C C.f t- e‘1(-)- Fa_i 15 (a__ S2/O�a W <br /> _ City State Zip E O <br /> Property Site Address: 7`i AJ-5 Pr'OSpec-4 .4Vt • nal-AIDuY( t-Ji . S"-q6'3 0" o <br /> y <br /> a <br /> Contact's Telephone Number: -7 8-- �'3y- )33 O a . <br /> d f <br /> Contact's Email: ...t-.E. e. 6 r u Ys!("h e r s 1 ir aj /nGt;I . L.c'', <br /> **If staff has a question about this application,you will tfe contacted via email. Make sure your email address is N - 1 <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and °Q N i <br /> @BurnettCountyWLgov <br /> 1IU ao b' <br /> (36 o F Y W1n' L�kE �SSESSb�I , �— <br /> Legal Description of Property: V��}rOB L , k �WELz EsmAir 5. O� <br /> Section#: 2.D Town#: yo N Range#: /CO W Town of: (CLk((irL c <br /> erzi <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* O F <br /> Tax ID#(1-5 digit number;found on tax statement): /V 6-75 d <br /> + d <br /> Proposed Use of Structure/Addition: S" 47 o r'c.3.e._ C <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ,J <br /> Building Contractor: Sewer Installer: W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> TUTS PERMIT IS SUBJECT TO _AT ', CONDITIONS .ISTFD BELOW! 1z <br /> 1 ._. <br /> • C�lke,-� cuA ' &I1Duc -S S <br /> N• co) In,ti.V ruvr\ \n.0 lv i"f `'oln <br /> • S .18 l OCGt i D✓t -I'0 he... V►/1.� -c4 i + S OU k' '� Vl/�L12- /' ` rt)(14- Fee Rec: 55`2 <br /> V2. Check#: 559� <br /> gr DpP.r--- tine .e-1-back. e-n1 ai I a@ i-e un-I d/A <br /> z <br /> 0 <br /> Date of staff site visit: 8'/21 /2023 Initi Is of site visit staff:' j m ' <br /> (ci U��Y� <br /> y = E <br /> APPROVED BY LAND SERVICES OFFICIA Q`DATE: U �26 � W <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT -< o z c. o <br /> R N..: Q <br /> Page 1of5 < `. 015 <br /> Burnett County,WI Land Use Application—Rev 3/2023 0 3 <br /> a .L. JJ <br /> 3 <br />