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LAND USE PERMIT APPLICATION—Burnett County, WI cr g <br /> Applicant Complete All Sections Below This Line 5' cn ro w <br /> n. <br /> Permit Types and Fees'Please,check appropriate boxes) C- <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 N 0 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 N <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 \� , <br /> 0 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 r <br /> X Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 �' W <br /> Filling/Grading $150 Boathouse $500 a, <br /> Mil <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 g <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. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. a "- <br /> Property Owner's Name: -Fh i i//n Lp L4,1))41, 1.4 <br /> Property Owner's Mailing Address: pill' 4t 6A-C L') RDC%33*r I A) / w. <br /> Property Site Address: , : ‘' <br /> ��� /�ar/'1 C(fri Laic CNrJ,�'C /��4 4/Y7p� 0 0 <br /> l FN <br /> Contact's Telephone Number: 5'o? 2 S /—0 3 Z a. <br /> 0 <br /> Contact's Email: // c vt 'q if q,I; 6 i'� <br /> **If staff has a quests n about this application,yovill be contacted via email. Make sure your email address is N - <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and 5, b0 ,= <br /> @BurnettCountyWI.gov o O <br /> Legal Description of Property: , ,, C lZ`Z�� S. .-C <br /> Section#: 2--1 Town#: 3 S' N Range#: / .7 W Town of: Ott el I. /S c4 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* " N <br /> — . B d <br /> Tax ID#(1-5 digit number;found on tax statement): V 1 /r H N <br /> Proposed Use of Structure/Addition: rlr pu A .1D <br /> Anticipated Start Date: - 14t e4-4, 2,4:z.3 T (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) W <br /> Building Contractor: vdN'it\I 0 1571 S4r`t 4/IC1,1 Sewer Installer: <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 70 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> DMck-f 1,00,8 a,U. d,i-htyls I V/K-ZS - i E' <br /> _, Fee Rec: l,25--eb <br /> Lig Check#: (p()7 <br /> CA SI) <br /> Date of staff site visit: 1, Initi Is of site visit taff: <br /> APPROVED BY LAND SERVICES OFFICIA : DATE: 12 Z l `k. = (�C���� <br /> 4 m a r Uuu <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT . 3 G_ <br /> Page 1 of 5 t � �� <br /> Burnett County, WI Land Use Application—Rev 5/2023 0 <br />