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LAND USE PERMIT APPLICATION— Burnett County, WI ., R b <br /> Applicant Complete All Sections Below This Line r F, A <br /> Permit Types and Fees'Please,check appropriate boxes) d <br /> VDwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 <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 j.? <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° y <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(ly)Structures $350 <br /> o (v !lb <br /> Filling/Grading $150 Boathouse $500 r <br /> w <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 ? <br /> ;v <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. `D <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. g . <br /> 0 1 <br /> Property Owner's Name:AWL 1f``�atl td kta de-(i(V 2t� S c <br /> 26(7 io WP� ,4 € �f 9: }�-/v ►o N S( a t <br /> Property Owner's Mailing Address: N ! n ✓i a <br /> City State Zip E 0 r <br /> Property Site Address: 26685 � � _Spa)C'0t49it1, Nee Vii < -� <br /> O y <br /> G <br /> Contact's Telephone Number: ,(Z—207—2.16e r7 <br /> 1 <br /> Contact's Email:A4045 21662 ) ct/yl Gt.' t •Go A4 C <br /> IF <br /> **If staff has a question about this appli ation,you will be contacted via email. Make sure your email address is N - <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 0 °' N <br /> 5 <br /> op <br /> Legal Description of Property: We-Si- ' O ( o v LD f 2-. q <br /> Section#: 011 Town#: 3ci N Range#: (q W Town of: R.l,l.Sk g• <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C' <br /> 0. .„ -, <br /> ,, <br /> Tax ID#(1-5 digit number;found on tax!� statement): 31:a 4.3 <br /> W <br /> Proposed Use of Structure/'`�jddit,on:t PQ V'MAAJ e AJ'r Rszs(t .e-tnc 2 -i W <br /> Anticipated Start Date: 1{//S/2"t (Home/Cabin;Commercial Business;Bedroom;Deck;;etc.) N <br /> Building Contractor: 4 g'y`� S204CI1 h o/fA e.S Sewer Installer:J6tC-kS0/0 ` l U.M-Y l J 5 - <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ) m W <br /> m Z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o z <br /> 0 Imeel- Olt S-e,A-I c kS m <br /> D:kArt,01;q1c) no4 - D ec(et d 3 I(Jcu*"CNYIs J Iii21-1-1 ° T Fee Rec:3 OD <br /> CiPt1J-1I(l �4 e d <br /> � � c4 IVt vl <br /> -l� '�" reSlC-�Dt�l ° Check#: lPS! <br /> z <br /> m <br /> r <br /> ` l J <br /> 0 <br /> rDate of staff site visit: ii122/2cri-q Initials of site visit staff T- ...,Q <br /> n <br /> APPROVED BY LAND SERVICES OFFICIA . DATE:1//Z0 <br /> � 7�/ co W 2. <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o o <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> CD MI <br /> Page l of 5 <br /> Burnett County,WI Land Use Application —Rev 04/2024 uL JJ <br /> 3 <br />