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r <br /> N <br /> Applicant Complete All Sections Below This Line F <br /> a so.) <br /> Permit Types and Fees:(Please,check appropriate boxes) v- <br /> 01 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 in - "t. <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 i <br /> XAccessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 I I y <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 { pp � <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1y)Structures $350 s i <br /> Filling/Grading $150 Boathouse $500 f d� <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 g <br /> s; <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. ._ <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. . y <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. b g. 'V <br /> �n�n� JacKs�n ° <br /> P t».�nfU <br /> Property Owner's Name: , <br /> ,-; <br /> Q <br /> a <br /> cc <br /> Property Owner's Mailing Address: V -Q3 ..a <br /> City State Zip K j <br /> Property Site Address:31 762 State Road j Danbury Wi 54830 ?-5 0 f <br /> p i s ce 0Y1 L( ® (AmC�,�sc A C a1 ` I C, <br /> Contact's Telephone Number: '`� <br /> i <br /> Contact's Email: 651-303-1236 j <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following addresses: (aBurnettCounty.org and g y <br /> g <br /> raBurnettCountyWl.gov v <br /> tJ33( ' 7c 1w/ 6. N.E5E (ju h ' en.4) Car-115-55) <br /> Legal Description of Property: J <br /> Section#:05 Town#:41 N Range#:15 W Town of:Swiss <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 0 X: <br /> 21222 v1 y <br /> Tax ID#(1-5 digit number,found on tax statement): y�n '� <br /> Proposed Use of Structure/Additi•on: Storage �JJ <br /> Anticipated Start Date:9/25/2023 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) r V <br /> Building Contractor:Self Sewer Installer:none SJ <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> 61ee, - a 11 5e+b4t `� <br /> 0�o� k7>( hit ,tn ijr4:6,1 <br /> x Fee Rec: i6--v <br /> oi <br /> d Check#:( <br /> tz <br /> / ';r <br /> Date of staff site visit: 10/3/ '3 niti is o si visit staff: RE.: .cou °" <br /> APPROVED BY LAND SERVICES OFFICIAL: ,�G DATE: �`T i? 2 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o 'nog N <br /> ,w w <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT , ralt <br /> n E. <br /> Page 1 of 5 C=::: <br /> Burnett County, WI Land Use Application-Rev 5/2023 <br />