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LAND USE PERMIT APPLICATION — Burnett County, WI ro <br /> Applicant Complete All Sections Below This Line 0' CD w <br /> Permit Types and Fees(Please,check appropriate boxes) <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 a <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 to—. <br /> 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 ' , -, <br /> cz 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 .. <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> it <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. i 1� <br /> ro <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. .• t <br /> z <br /> / 0 <br /> Property Owner's Name: A/A- ,[`3.... r n c_ 774- %/cc 71-r ,r C_ r] <br /> a. <br /> Property Owner's Mailing Address: /O0/ ,514 74z. P el' 3 s. C,„ •,,' 4.Jr 5Yc" y . <br /> o n City State Zip ` P" <br /> Property Site Address: 7)-l 2 5i -7/c /ecxe 70 *z o a, <br /> • <br /> Contact's Telephone Number: 7/s —,. S 3- U 73 1 <br /> n. 1 • <br /> d <br /> //Contact's Email: tr" . ��c� A) /A .kc tf co i--1 ep <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 °O <br /> @BurnettCountyWl.gov ago <br /> Legal Description of Property:G o f / L'S/I jE.3.3-5 7 (// ; P `3-! ,lt. /2L/O TIP/76 R � <br /> Section#:533 Town#: 3?i6r N Range#: /6 W Town of: Me c no cn <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* \ ' F <br /> Tax ID#(1-5 digit number;found on tax statement): . 3 3 76 0 <br /> < H l./J <br /> Proposed Use of Structure/Addition: .S/c.r'-3 c_ g,y 41 3 (, <,i- Vol w <br /> Anticipated Start Date: ASAP (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) • <br /> Building Contractor: 44r f A /�n x A .14,-,f5 Sewer Installer: LIE) L-- <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m <br /> z <br /> THIS PERMIT IS SUBJE T TO ALL CONDITIONS LISTED BELOW: <br /> 0Me'e+ 411 e11bA 5 �' <br /> c(fINd1- ;r JYV1411 Ji U'4 �✓I <br /> ,�[[ W V _6° <br /> ,, INd� � e1CG�� �`� �� ff I_ x Fee Rec: �� <br /> --) XU2 to 4CI.�55 0L4 . +v !c J CJ ti,k5 i �p._c ks a/'_ o Check#: l 1.531 <br /> I(ao° oW4er iN S ,454b,"It , `/ 6 i w qe ri-Or, <br /> z <br /> � v <br /> Date of staff site visit: 1' 123' Ini ial of si v' it staff: �r am\_Jji <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: 0/2/2-3 .a_c. <br /> co <br /> IM <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF m <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT fl <br /> N <br /> Pagelof5 w <br /> Burnett County, WI Land Use Application-Rev 3/2023 - fra <br /> LL <br />