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LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> b <br /> Applicant Complete All Sections Below This Line 0 .cn A <br /> CZ- <br /> Permit Types and Fees�Please,check appropriate boxes), � C7 <br /> Dwelling/Principal Structure $300 _Addition/Alteration to Dwelling/Principal Structure $200 ° W <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 K �o <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 LJ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 ''g_ V <br /> Filling/Grading $150 Boathouse $500 N <br /> m <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. 1— <br /> *Communication Towers, Camping Permits&Signs require a different application form;see corresponding application,and fees. g <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. <br /> z <br /> 0 <br /> Property Owner's Name: R b a.i` L KNi 'Ty o us <br /> v•e N C_kn, R. ' %,, t- 5 � . iii N <br /> Property Owner's Mailing Address: Z�� 67 �.►�lout', `�� n <br /> City State Zip 4 <br /> Property Site Address: t'/1(0'7 F Y-.e A:C Z o, IJ ,vV"li 1 t.J 1 '':31� o y <br /> Contact's Telephone Number: 31 L go 2--- 31� n. <br /> �j 1,... C7 <br /> Contact's Email: f`O►b e v.-1-d e_ i i S. e 0 V► I CA S 1 0 eT .6 =' <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is �' ti � <br /> legible and your email provider will accept emails from the following address: @,BurnettCountyWl.gov o °Q W <br /> , n'" <br /> Legal Description of Property: NGr NW EX CSM Vr 2lp Rig d ,� <br /> Section#: s. <br /> rO Town#: N Range#: W Town of: K IC,�,., <br /> 3. <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* ' <br /> 73 .-.,10 <br /> Tax ID#(1-5 digit number; found on tax statement): 3 1 b Z g Vs-) U g d <br /> Proposed Use of Structure/Addition: W0:41 e. CO^J(,r e IV" Q ci l l 0 H Q �J <br /> Anticipated Start Date: ' / Z 2/ G 04 y (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> s A. <br /> Building Contractor: 5 0 - Sewer Installer: y d <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY a <br /> rriz <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> 0 inet+ atil kittaci.S rr, <br /> CAtf-l-ic '/ I ^ 40 6, J r. �n a loci r�d � itiZ ��6 t�(.I �GUI'G�' V"�'" ' Fee Rec: A254) <br /> Z Check#: c:2?`I' <br /> r <br /> -C <br /> Date of staff site visit: Li /6/ZoZq Ini *als of site visit staff: d- & L o <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: q/W2 3 II,�,,,n��� <br /> ° n L► Ll ll <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF co o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT c. <br /> o 0 <br /> Pagelof5 2 <br /> (1, ifUli <br /> Burnett County, WI Land Use Application—Rev 12/2023 <br />