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LAND USE PERMIT APPLICATION - Burnett County, WI a � <br /> Applicant Complete All Sections Below This Line 0 c (A)r n <br /> Permit Types and Fees(Please,check appropriate boxes) 6- <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 ,D O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 G� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 � �? <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 t) <br /> Filling/Grading $150 Boathouse $500 R\ <br /> co <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. `: I <br /> *Communication 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. <br /> nn / I <br /> Property Owner's Name: IT) ALE A- L.4 RS'0!v o <br /> Property Owner's Mailing Address: n.'3 Olsen / c L P6 s 1-e( Cli I 5' 73 a.a <br /> n <br /> �j nE <br /> Property Site Address: 7S g-/'3 0 lS�!l >�d 1,� b,5 J'r l) City �_,` 2 q3 Zip <br /> Contact's Telephone Number: 7/5— q q l — ` (o Ce . a <br /> n d <br /> cif aContact's Email: ` rs z)n (-.-'/ �1 <��z„,a l Irim `, 0-6 r +, <br /> **If staff has a questi bout this application,you will betontacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and oa °Q <br /> @BurnettCountyWl.gov a <br /> i d <br /> Legal Description of Property: Pa. NE Nr <br /> Section#: /0 Town#::3(i N Range#: /7 W Town of: L i tl e t)/it <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* M . , o <br /> Tax ID#(1-5 digit number;found on tax statement): /© � 0 5_ <br /> Proposed Use of Structure/Addition: -S "i r( pp <br /> Anticipated Start Date: /'(Q l I / 3 (Hake CCabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: _ JCL)E �` S Can Sewer Installer: n/A . <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 0 r✓lee+ a I 1 se+ cics <br /> pi,* -fir . A4 /kh,(4)v" <br /> h <br /> Fee Rec: 1/ <br /> v Check#: ;-7 3q <br /> m <br /> z L J <br /> Date of staff site visit: 9 iiaa3 Initial of ite isit staff: j* < = [ <br /> / m cn c <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: //3/23 v, < ? -0 0 <br /> nil <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o 0 0 <br /> z m c r"~ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT ; <br /> Page 1 of 5 m <br /> Burnett County, WI Land Use Application—Rev 3/2023 v <br /> a <br /> 3 <br /> -o <br />