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LAND USE PERMIT APPLICATION — Burnett County, WI a " r <br /> b <br /> Applicant Complete All Sections Below This Line o CD I <br /> Permit Types and Fees(Please,check appropriate boxes); a <br /> d <br /> Dwelling/Principal Structure _$300 ,Addition/Alteration to Dwelling/Principal Structure $200 %� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 I <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° F • <br /> X Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) .$150 Permit Extension(1 Year Extension-Allowed Once) _$100 fl <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. `D <br /> *items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o ... <br /> z <br /> a <br /> Property Owner's Name: i vl. Qi,vd c3-' . o m`' <br /> Property Owner's Mailing Address: a,5S(26. 5 Da.w-• (�cA wQ b.c € 't � 1 S 813 I. r <br /> Property Site Address: 7-5�r,2 S O o_;ra-4.CL , 5.1—,�/-.' t, c.`71$rt3 • <br /> o N <br /> Contact's Telephone Number: c,^ 33 €1 - $1 �S a <br /> ROOjt « v�� ( , G <br /> co <br /> Contact's Email: ��jj �� `' <br /> **If staff has a question/about this applic�n,you will be contacted via email. Make sure your email address is N ro <br /> legible and your email provider will accept emails from the following gaaddresss: @BurnettCountyWl.gov 0 00 <br /> Legal Description of Property: S 2"O t a- N '1 p C O- ,S U r V W (ç,, I)/ g.4-F) . <br /> Section#: c0 Town#:3 t N Range#: I W Town of: M e..e w D IA. 0 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* 'p r <br /> Tax ID#(1-5 digit number;found on tax statement): <br /> Proposed Use of Structure/Addition: 5 Jitz De ch, . v '") <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> i W <br /> Building Contractor: Sewer Installer: y � <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z x o v. <br /> 6ei'i ' ' I`5 �fr Q SAe�c O� die- we57L S/fie ta o / m S 1 <br /> yV <br /> .Dqr 4hc/ q �c4- & & � h0USe-C� r e/qc-� n <br /> �T o a i; <br /> q t e4(l`S cn <br /> �7 Per , -� Fee Rec: �-7 5 <br /> r <br /> 1 'Ae C/ ho f 7‘ A e, Gu S ed' �v' tt a o-A.01i GI ce / 7L4 :"„1• z Check#: i (o-t-/ <br /> / r <br /> 5 S'A el li e1 74v b� use- t�'r^ co l ti'i t ca 4 0o u r/H e s$ <br /> ni <br /> • <br /> ni <br /> Date of staff site visit: 05- 2007 Ini ' Is of site visit staff: / /• o r �� <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: VZ--//7—e9eY V y lin <br /> CD c <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 3 _° <br /> 00 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT sii K 0 <br /> Ind <br /> Page 1 of 5 0 - <br /> Burnett County, WI Land Use Application-Rev 12/2023 I "--7J <br />