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LAND USE PERMIT APPLICATION — Burnett County, WI a 0 <br /> N <br /> Applicant Complete All Sections Below This Line c w <br /> Permit Types and Fees�Please,check appropriate boxes) a 1 <br /> d <br /> `-' <br /> !Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 `; <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 ,.� g <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 G� V.," <br /> `Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °_ <br /> %' Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 S' U <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 I E <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. '� ` <br /> ro r <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. 0 i <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g' "' <br /> z 1 <br /> Property Owner's Name: ►3'UZT%\ -Dc F' 't�(LUFee`1 ES ✓ 1 LL(i o <br /> Property Owner's Mailing Address:OD C'o U to bAlvat -) (A)i 51-10 i` n t <br /> i y - State Zip ' "' • <br /> Property Site Address: 7-Cl Zi 1 r-k Ay D�iJ LA KL Rv417 1 ife'z o y r <br /> Contact's Telephone Number: 11 o IC'" 2/.34—40 .3 / a. <br /> Contact's Email: V.5LLi✓E ® 'KY)12T CA-virpp...Ot'E►:T1E5,Com v . C <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> ro <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and °0 <br /> m <br /> @BurnettCountyWLgov <br /> P. 0 <br /> Legal Description of Property: 5W Sui J EU Y S ESE I(a ( P ce-L$r j -1 q 3) E. <br /> Section#: Cj Town#: LID K. N Range#: I 0 W Town of: 0 KL D 1'4 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* i(v,�_' <br /> Tax ID#(1-5 digit number;found on tax statement): I O4' C7 <br /> H <br /> r <br /> Proposed Use of Structure/Addition: I S <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) .-c-- <br /> 6Building Contractor: Sewer Installer: c--- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> r7eel--l1 5e .c�1S <br /> Fee Rec:$76S(2g. <br /> v Check#: 3.710 <br /> z DPnnti QLa� <br /> o <br /> Date of staff site visit: 0'W /a 3 Ini is of site isit staff: he cn <br /> < <br /> r In4W�, <br /> p y Cy <br /> BY LAND SERVICES OFFICIAL: DATE: D h0 3 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o i __''''' M <br /> 0. Co <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ' `° _ �ti.a <br /> a w 7 e:_, <br /> Page Y of 5 < C <br /> Burnett County,WI Land Use Application—Rev 3/2023 v ? <br /> 3 <br />