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LAND USE PERMIT APPLICATION —Burnett County, WIcr <br /> R b <br /> Applicant Complete All Sections Below This Line a c w <br /> CD I <br /> Permit Types and Fees:(Please,check appropriate boxes), <br /> a <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 �� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 SI h o <br /> Y Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 e� n <br /> 1� Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o <br /> Driveways/&Campground Structures <br /> Y Pg $125 WI State Statute 59.692(1y)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 � <br /> v, <br /> Solar Panels(Stand alone or roof mounted) $150 _Permit Extension(1 Year Extension-Allowed Once) $100 <br /> o <br /> "NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. / <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. 0 <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. S (1 <br /> z <br /> Property Owner's Name: Chr-ksi-ti,r ML�ly-,bex '� lb <br /> c <br /> Property Owner's Mailing Address: I6$C13 Ae1.03OD cL , ', yr` f f•4c7/ 1' tl , 4S-34 ‘ <br /> h // �//� + City State Zip E <br /> Property Site Address: 2JP(YC2 7 1...- I /4. i, P o y <br /> Contact's Telephone Number: (01 a v04-- 534-( a <br /> �(( ' Pi <br /> Email: C \ (C L., 4 C.D \(& . Ate_T : <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is b <br /> legible and your email provider will accept emails from the following addresses: @BumettCounty.org and o °O <br /> @BurnettCountyWL.gov ei. <br /> i F. <br /> Legal Description of Property: L �J 1 (� `� c� kr E. <br /> Section#: ) Z. Town#: 39 N Range#: 1:‹1(0 W Town of: t'LnfDA <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* \ o <br /> `� _ <br /> Tax ID#(1-5 digit number;found on tax statement): I � t 1 d <br /> Proposed Use of Structure/Addition: faCst, 5}ve_41, \�)t ) it) <br /> Anticipated Start Date: a (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) W ,..z, <br /> Building Contractor: Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDUTIONS ONLY x) <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> d Thee4 A11 501k i.o <br /> e NOT- fr.( ,4,,an4 4 .64. <br /> 54,,;,,-3 ID w need Deck./5 i rs ref/714 0.l/l2 3 <br /> g Fee Rec C 150 <br /> 5 Check#: 1 35p3 <br /> Date of staff site visit: T 1/24 23 I ilia, of site 'i 't staff:-..� << = ff <br /> a <br /> ai A C P: <br /> --, a <br /> APPROVED BY LAND SERVICES OFFICIAL: ., , / '' DATE: 5113/a ? u, m i•LI <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o 0 0 — <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT CO <br /> Page 1of5 = R. <br /> < ' _� <br /> Burnett County,WI Land Use Application-Rev 3/2023 v <br /> k <br />