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LAND USE PERMIT APPLICATION — Burnett County, WI a i <br /> En <br /> Applicant Complete All Sections Below This Line 3' w <br /> Permit Types and Fees(Please,check appropriate boxes) a <br /> d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 CD `'%0 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 6, <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> CD <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> G) <br /> o <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < , <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 C" <br /> 0 <br /> Filling/Grading $150 Boathouse $500 cn a <br /> co <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up tothree times the normal fee. `q <br /> b <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. .9 <br /> .k <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> z <br /> Property Owners Name: o <br /> e 0 <br /> eEs� n 6, <br /> . <br /> Property Owner's Mailin Address: /5� 6 ' � 6S7o�y $ <br /> 2.509q4/41,1#10 <br /> City State Zip ;� <br /> Property Site Address: nA, .Q4 Ct t kQ-', <br /> 4:: o c , v <br /> Contact's Telephone Number: Q63 —,6-6. 6 a c • <br /> n <br /> Contact's Email: /11 1 K c • /►� b . , ..�,.ti� „i„, <br /> **If staff has a question about this applic tion,you will be contacted email. Make sure your email address is N <br /> legible and your email provider will accept emails from the following a dresses: @BurnettCounty.org and V °Q <br /> @BurnettCountyWl.gov o <br /> F.g DescriptionProperty: `-fT al Cyr 51 17 Vd I G2 i ?5a Rec Jc a '47Lj(O . <br /> Legal of Pro e / S r> p 1 <br /> Section#:33 Town#: J ci N Range#: /� W Town of: /fill e4�7bcn•'1 (v, <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* N f ' <br /> Tax ID#(1-5 digit number;found on tax st ement): 3 600 q (N d <br /> Proposed Use of Structure/Add' ion: de �rl <br /> Anticipated Start Date: /r) . 2- (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> 1 8 <br /> Building Contractor: Sewer Installer: =p <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> [..0:—... <br /> iviee4 a GI ,fie ufti <br /> 0 iV hk i i 44 b'ir-t-Cco <br /> x Fee Rec: f�( ) <br /> o Check#: cQcQ./Y <br /> cz <br /> z <br /> v <br /> Date of staff site visit: /121v3 rof ' e v sit staff: di' t. <br /> tz <br /> < , �.�J <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: Oilycr) EMI <br /> a. <br /> = <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z ti <br /> � <br /> ry <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 r—i <br /> N CC <br /> Pagelof5 < a> w <br /> Burnett County, WI Land Use Application-Rev 3/2023 v Ira <br /> T. <br /> cn <br /> o <br />