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•° r <br /> LAND USE PERMIT APPLICATION —Burnett County, WI L <br /> b <br /> Applicant Complete All Sections Below This Line c <br /> Permit Types and Fees(P/ease,check appropriate boxes) <br /> C7 <br /> 'b. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 (O <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 /> C) <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 _ <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> 0 <br /> Filling/Grading $150 Boathouse $500 lli <br /> w <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 to three times the normal fee. $ r <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. o =' <br /> z <br /> o L <br /> Property Owner's Name: Jerrold Buggert o N ; <br /> o 'T <br /> Property Owner's Mailing Address: 5753 Hwy 85 N 2671 Crestview FL 32536 , n <br /> City State Zip ° E <br /> Property Site Address:28181 W Bass Lake Rd Webster WI 54893 c y <br /> Contact's Telephone Number: 949-632-6164 W a <br /> 1 :' o <br /> Contact's Email: buggertfamily@cs.com <br /> **If staff has a question about this application, you will be contacted via email. Make sure your email address is N -v <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWLgov = CIO <br /> 0,0 <br /> N <br /> Legal Description of PropertyLOT 12 CSM 5341 VOL 30 P 224 DOC 485092 (NW SE &GOV LOT 2) d N <br /> 23 40 15 Jackson <br /> Section#: Town#: N Range#: W Town of: <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* cn <br /> O Tax ID#(1-5 digit number; found on tax statement): 36767 �p K <br /> W i o <br /> i <br /> Proposed Use of Structure/Addition: Deck <br /> Anticipated Start Date: April 20, 2024 (Home/Cabin;Commercial Business:Bedroom:Deck:etc.) —3 A <br /> Building Contractor: Randy Bowman Sewer Installer: n/a t2 O <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY o z 0 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z 70 <br /> o <br /> Oro/l o l,1/4) a it C-e'ACZ4 0k 5 05 4141 41 01 & .- Z LI —0 6 . rri <br /> r <br /> Fee Rec: ' - <br /> z <br /> Check#: <br /> l <br /> q <br /> Date of staff site visit: 2 ,l/ zoo/ Inirals of 'te visit staff: /�' IT <br /> T -0 0 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: V//06,a-V m `-° hid <br /> I oo Q, uuu <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF l <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT -_ <br /> ra <br /> Page 1 of 5 Q �J <br /> Burnett County, WI Land Use Application — Rev 04/2024 <br />