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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> Applicant Complete All Sections Below This Line o• c w <br /> Permit Types and Fees(Please,check appropriate boxes) <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 i <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ 0 <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 /> G) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures o <br /> y pg $125 WI State Statute 59.692(ly)Structures $350 <br /> Filling/Grading $150 Boathouse $500 v) 14 1 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 N 1. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. 8) <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. 0 v1 <br /> z <br /> 0 <br /> Property Owner's Name: p la,V ID 'FU-55 0 .-.0 <br /> Property Owner's Mailing Address: cz,277 4 70 P RTT '` n <br /> c City State Zip <br /> Property Site Address: cJ`f tiV`E '- • o <br /> ,( <br /> Contact's Telephone Number: Ip 12. — 2. D I — 5 3 35 n <br /> Contact's Email: K 1`/i co`:,`7G0 k4o N'v/ar i L._ ,Co \ d <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is ro <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and o�i' 0,- <br /> @BurnettCountyWLgov LO j 9 C S/'i // 3 3 Vo L ;'P y y <br /> Legal Description of Property: '`{', <br /> Section#: :I?1-1 Town#: y0 N Range#: / S W Town of: J7I4 CK 5 0 N v) <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 7 F <br /> Tax ID#(1-5 digit number;found on tax statement): 5 q17� <br /> 1 <br /> Proposed Use of Structure/Addition: f-fRE ,f�'/1-1 (.� <br /> Anticipated Start Date: (_O pie L tE4? — (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) it*-3 ¶ (-.--- <br /> Building Contractor: Sewer Installer: �� v <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: _ <br /> 10 ytdd a 11 C,04 1+ d4 5 o.0 VAP- 013-6 7 01 <br /> x Fee Rec: <br /> E <br /> 4 c#:it125 <br /> CASi1 <br /> z <br /> 0 <br /> Date of staff site visit: LI/13 I?3 Init' of a"silt staff: Fly 5.x r �Ji.___i <br /> APPROVED BY LAND SERVICES OFFICIAL: -ze:- DATE: /0' /?3 y c� irtn <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF z ",-I N <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT m = N <br /> Page l of 5 < § `''' <br /> Ify <br /> Burnett County, WI Land Use Application-Rev 3/2023 0 J <br /> a 2- <br /> t, <br /> b <br />