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LAND USE PERMIT APPLICATION — Burnett County, WI c <br /> . b <br /> Applicant Complete All Sections Below This Line 0 <br /> Permit Types and Fees(Please,check appropriate boxes) C7 <br /> o. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $ Addition/Alteration to Commercial/Industrial Structure $200 0 <br /> X <br /> /` Accessory Structure(Garage,Shed,etc.) 150 Addition/Alteration to Accessory Structure $150 9 g� ni <br /> Accessory Structure(Commercial/Industrial) $ 0 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 0 r• ►i <br /> a <br /> Filling/Grading $150 ,Boathouse $500 a, <br /> co <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 0. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r aa. <br /> z <br /> Property Owner's Name: t a►^ e r�s,'`rr ��t (� o <br /> Property Owner' Mailing Address: 1l f ljZ �I�U� Y,V YVWt ��VD� E <br /> �/���(� r I - ,,,,so. Mate Zip ° <br /> CID <br /> Property Site ddress: rlWIJ i CCN Ct(Qv1 61 /\ • <br /> -- 4Q l� ✓ t"1_ o N t; <br /> Contact's Telephone Number: a- OV I- ' ‘ <br /> ,ten ay ,,.Ca.0 o$ QvL- '' `' v <br /> Contact's Email: ' II`t�v` <br /> **If staff has a question about this application,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 address: @BurnettCountyWl.gov 0 °Q <br /> Cof'Zao <br /> Legal Description of Property:. -C-s UOii Q o <br /> / 0. <br /> Section#: a� Town#: l of N Range#: Ill W Town of: UAid vn t S <br /> *Attach additional page i needed or lengthy description OR attach a copy of the deed OR attach tax system prop�ry page.* En <br /> P S f f g V . <br /> Tax ID#(1-5 digit number;found on tax statement): 2.-© (p 3 i <br /> 1 _\ d <br /> Proposed Use of Structure/Addition: Yager &cex2 �� <br /> Anticipated Start Date: ( ome/Cabin;Co ercial Business;Bedroom;Deck;etc.) s n` <br /> 1 �, ((�� I 2 Iv <br /> Building Contractor: (��`�'� �`a �dl✓ Sewer Installer: (.0 N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m 4" <br /> z S ,p <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o pzi <br /> 0 /Vo/ be. (A$ two-Aoki tu �oki A44/74 4 4. er <br /> 410 �o1—74, Pic,e.e_c/ 4 A e-,9 f- o Pqo �[eo !� y <br /> 3 ithe �' a / Tara s/ Q a/c/1/ESS D 7///�z i e Fee Rec: /'"?��L= <br /> l / ° Check#: li <br /> r- <br /> r <br /> Date of staff site visit: ����Z� Initi s o site vis' ff: 7i/' o r <br /> rn co <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: Ø/ o <br /> L� > 0 coD <br /> a CD c V V <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> coo rr; _ <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT o Q <br /> CD <br /> Page l of 5 <br /> 3 <br /> Burnett County, WI Land Use Application-Rev 12/2023 (t JJ <br />