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LAND USE PERMIT APPLICATION — Burnett County, WI CA <br /> r <br /> b <br /> Applicant Complete All Sections Below This Line o w <br /> a. <br /> Permit Types and Fees(Please,check appropriate boxes) <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 K Ni <br /> :: <br /> Commercial/Industrial Structure $300 .Addition/Alteration to Commercial/Industrial Structure $200 o\` <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 co <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> $' Zu <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> 6 a. Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 ).) d <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension Allowed Once) $100 I <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. ` _6' <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. 1 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r <br /> Property Owner's Name: r\ ( ))0-6 ni-4-ipit_. 9 p <br /> IN Property Owner's Mailing Address: 504 Sou+hfo r� I ( 11 S 2 P1 V j/f �/p <br /> Property Site Address: aq a(�' rf avctcr► uA Ke ga t� I� � �h t�(Z 0 <br /> Contact's Telephone Number: 1- Z1 I , ) d <br /> Contact's Email: leg‘ICt C4 Ulsei I 0 \a/ bO. CO6 ! =%**If staff has a qution about this application,you will contacted via email. Make sure your email address is N ,0 <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and °a °Q <br /> @BurnettCountyWLgov A. <br /> II ' /c� 1� C 7 v <br /> Legal Description of Property:Kl� W� `q 4`-� Va P p '•DI bG /, � z. <br /> Section#: S Town#: q 0 N Range#:_ I Co W Town of: eY,Jt 14 R <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> f� l ' 1 <br /> Tax ID#(1-5 digit number; found on tax statement): 3 51.( � W <br /> -3 lb CA <br /> Proposed Use of Structure/Addition: t4 U 1 <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) r <br /> Building Contractor: Sewer Installer: I <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY x <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> Med All S <br /> aw L iitou4 , 4 <br /> nn <br /> s Fee Rec:is/ 6 <br /> o Check#: ]�.7L <br /> J6S4A- RI'1 Q'r- <br /> qf J1 �3WJ <br /> Date of staff site visit: I/ i ial of si v' it staff: -t ICI < <br /> APPROVED BY LAND SERVICES OFFICIAL: � DATE: i �a -/.3 I ro�° ril <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o WO <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHTco <br /> 1.711 <br /> Pagelof5 � _ <br /> Burnett County, WI Land Use Application-Rev 3/2023 c <br /> U. <br /> i <br />