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LAND USE PERMIT APPLICATION— Burnett County, WI <br /> w• 7 N <br /> Applicant Complete All Sections Below This Line 0' a .. <br /> Permit Types and Fees f'Please,check appropriate boxes) p v <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200et <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p <br /> X Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 c� <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 C) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c <br /> Filling/Grading $150 Boathouse $500 Cl) 0 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 2. <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. r <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 9 z <br /> 0 <br /> Property Owner's Name: VJ v o �' <br /> P' % � I c'l 0 1 U,; SYaZe1 <br /> Property Owner's Mailing Address: Cl) <br /> `' `�, -J- _ ity State Zip K <br /> Property Site Address: - 't ` ' 1 Ci I n St (jiAr)1 J)rr\\ o c <br /> Contact's Telephone Number: 1 I C �4 S 3 v C o <br /> Contact's Email: -'\--b`v,it1 lAS 1/4^'I , pi9 1-N Irt, ' e i, ("1 <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is re: ., <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov . <br /> Legal Description of Property: Q-) -W-1.. - 01. LA l I k#' a t - I 0 4_ oto -I�as o VI <br /> Section#: 1 Town#: L( ( N Range#: I ( W Town of: S V.') ` 3. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 7i Cl) <br /> p x <br /> Tax ID#(1-5 digit number;found on tax statement): �1(� 0 �� N oa o <br /> Proposed Use of Structure/ dd. ion: t"l (-�I L 1" G. \-' <br /> 1 1 ( � %'1 -I <br /> Anticipated Start Date: s� X� (Home/Cabin;Commercial Business:Bedroom;Deck:etc.) �, •, N <br /> Building Contractor: A ix�c-r'4.11_1-`!v S�-V- Sewer Installer: 1÷1 1 v <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY 1 C6 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: i : <br /> CI nil!tt C(Alt Yt-kbaS 1 ---- <br /> i <br /> O <br /> 2 NO4t) VWIJ 6. d .For hainw kt4JoiIa,+i&'l 4 Fee Rec. /(1/i- <br /> 2 Check#. <br /> l Z� Initials of site visit staff:el— c sv ���~-- <br /> Date of staff site visit: -�I �u'1 4 I I <br /> MIAPPROVED BY LAND SERVICES OFFICIAL �� SATE: ✓/qJz0i1( �#CD�EC) CD <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF . <br /> CD ^, NO <br /> 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT N <br /> Page 1 of 5 g <br /> = w jjll] <br /> Burnett County,WI Land Use Application-Rev 12/2023 j 1 <br />