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DocuSign Envelope ID:6C6DCOAB-11A2-4F43-A25B-6A2690EC94D0 <br /> LAND USE PERMIT APPLICATION —Burnett County, WI a b <br /> Applicant Complete All Sections Below This Line 0 A <br /> Permit Types and FeesPlease,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 v� 1 <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 /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 e. 0 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <br /> X 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. <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> r 0 f <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o z <br /> P <br /> Property Owner's Name: John and Alice Sylvestre o -- N <br /> O — <br /> 1264 Energy Ln, St Paul, MN 55108 -at <br /> Property Owner's Mailing Address: 5• c cN <br /> City State Zip E N <br /> Property Site Address: 5421 Lake 26 Rd, Danbury, WI 54830 <br /> C <br /> Contact's Telephone Number: 651-842-9404 4' ro a 1 <br /> Contact's Email: permit@allenergysolar.com <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b p <br /> legible and your email provider will accept emails from the following address: @BumettCountyWl.gov I00 N <br /> Legal Description of Property: OT 1 CSM 5218 VOL 29 P 294 RECORDED AS DOCUMENT 478912(NE NE) G '�- <br /> Section#: 29 Town#: 41 N Range#:15 W Town of:SWiSS ..0 4 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> N o <br /> Tax ID#(1-5 digit number;found on tax statement):36360 .� d <br /> Proposed Use of Structure/Addition: Rooftop Solar on cabin -� vl <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: All Energy Solar Sewer Installer: Q <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY to z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z <br /> 0illfe7- 011 stic5 o <br /> rri <br /> c. <br /> eC L nk [ill, u.leQ Vt a led92°1 alr7 FeeRec: /50(27 <br /> I l'lzoi ° Check#: 3.Z2.) <br /> 0) <br /> Date of staff site visit: I I I?1 Initials of site visit sta . d- L 1 ` l <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: q ii <br /> inn <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF < -0 0 <br /> CD ST-) enli nil <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 o <br /> Page l of 5 <br /> Burnett County,WI Land Use Application-Rev 12/2023 <br />