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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI cr <br /> b <br /> N <br /> Applicant Complete All Sections Below This Line E w <br /> Permit Types and Fees:(Please,check appropriate boxes) o ° <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 rc <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 CP <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 \ , f' <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c ` `, <br /> Filling/Grading $150 Boathouse _$500 w II' <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 (n <br /> i. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. v\ <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. rn <br /> 11 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o <br /> z filik <br /> 0 <br /> Property Owner's Name: &jail— iNN4Gnit- o "----- <br /> Property Owner's Mailing Address: )36C41 l.<Pf'bk, Av1:' S . 0uHnr3v24..A.F mg 55337 �. <br /> nri <br /> City State Zip 4 <br /> Property Site Address: (9Y53 S. VEZYT R. jjp413,,431 t MN 91830 o ;, <br /> • <br /> Contact's Telephone Number: <br /> P 651"9(01— 03S5 CoKY wtAacoN <br /> FO <br /> Contact's Email: Cory.nioo ort QI;ndosea .cv.z-r <br /> **If staff has a question about this application,you will be contacted 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 = °q <br /> @BumettCountyWI.gov r <br /> Legal Description of Property:P P rtyLea' 15 GS m V $ P rain/ ..� <br /> Section#: I W Town#: lid N Range#: I to W Town of: OgrLp,.,7 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* '� o x <br /> X. — <br /> CI <br /> Tax ID#(1-5 digit number; found on tax statement): I33Z5/ y 0 <br /> Proposed Use of Structure/Addition: C n-i <br /> Anticipated Start Date: q hre j 2'3 (Home/Cabin;Commercial Business;Bedroom;Deck:etc.) <br /> ^ <br /> Building Contractor: LTr.rpu. Cows c.r N,,. s, Sewer Installer: , .-z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY i.:6._THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: - <br /> if Mee,- eI( st-43,4 <br /> (Vol re uic W,si peals 01/64- 4 b4 esicloseet) <br /> Fee Rec: I.2iw <br /> d Check#: I 0 (035— <br /> n, <br /> r <br /> z <br /> Date of staff site visit: 9 f"?l?3 I 'fiat of site 'sit staff: PE 1-1 fa) <br /> ,. E <br /> I / <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 13I�� Z 3 r % C� <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o 0 C <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 3 crJ <br /> Page l of 5 < IL <br /> til <br /> Burnett County, WI Land Use Application—Rev 5/2023 d <br /> z <br />