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LAND USE PERMIT APPLICATION - Burnett County, WI . ro <br /> a <br /> Applicant Complete All Sections Below This Line g' c w <br /> co 1 <br /> Permit Types and Fees(Please,check appropriate boxes) a kr' <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 C <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 n O\ <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 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0o <br /> Driveways/&Campground Structures , <br /> Y pg $125 WI State Statute 59.692(ly)Structures $350 S' , <br /> e <br /> Filling/Grading $150 Boathouse $500 a <br /> r <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. s5 <br /> 'if' <br /> Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g• c. <br /> F <br /> z <br /> • <br /> Property Owner's Name: C' Y`�S'1L� 'F(�,h, ML U,l�Yl 'ram o , <br /> Property Owner's Mailing Address: 161c 13 L )0D ck, ,3r, Mei jW,,7\v/ m i a n <br /> /�7� // City State Zip `" <br /> Property Site Address: L �10�J 1,-.1I f � , <br /> p��/, I 2!� •o a <br /> Contact's Telephone Number: (Oi o�" O04--- $3 ` ( d <br /> a <br /> Contact's Email: an r( 0 CO\C.CA.A-. r\L : <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ro <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and ° "0 <br /> @Burn I ettCountyWl.gov <br /> Legal Description of Property: 5 -7(45 1 p F g- .5 G 6.6 Nr g. <br /> Section#: 1 Z Town#: 39 N Range#: RI LQ W Town of: Mee.,n0A tn <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* \ . o <br /> Tax ID#(1-5 digit number; found on tax statement): I � 1 1 d <br /> y <br /> o <br /> Proposed Use of Structure/Addition: S e 1-1.74 ) (p <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) 1 <br /> r, ! ---Z <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 /> 0 a!l Sefbbea I• <br /> y Nperf ( Iltti, 4 L.1A- <br /> 40 ,,,;irs walk,/ aeecl 0ecit fsJ- ri/i1 3 <br /> x Fee Rec;ii l 50 <br /> o Check#: 135C)3 <br /> m <br /> �1 / v <br /> Date of staff site visit: i//-! )3 I itial of site vi it staff: .�C < = <br /> �l�,J // m f <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: !? ? �' m i . a <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o 0 0 -- ffl <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT A r <br /> tit <br /> Pagelof5 rn a <br /> Burnett County,WI Land Use Application—Rev 3/2023 v �� ij <br /> cn <br /> a <br /> 3 <br /> -o <br />