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y ,, LAND USE PERMIT APPLICATION — Burnett County, WI . <br /> Applicant Complete All Sections Below This Line 0 c <br /> Permit Types and Fees(Please,check appropriate boxes) <br /> C <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 <br /> 1 <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 R? <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 r <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 0 hh <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o ..C., I <br /> Filling/Grading $150 Boathouse $500 v) <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 E.\V ' <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. 44'1.-- <br /> ro <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. "' <br /> z • <br /> ►r <br /> Property Owner's Name: ]�ryp,• iL t t,1"�,�Q ---Cup tT o V W <br /> Property Owner's Mailing Address: a7576 `>ll,4y 64/t Yee Lt) l,a0% �I g'I � n <br /> City State Zip 3 -k r <br /> Property Site Address: 7Z t' nakiisai Pf' I°'`"d'"It Ji.,...n. ,n <br /> •o = it <br /> Contact's Telephone Number:. I5-2 C —753 , ,�\ a. ►s <br /> \" d , \ <br /> . <br /> Contact's Email: dC1 ogr,A_ L C. ryua( . Co vvt <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following address: @BurnettCQ'ountyWl.gov c° °O <br /> Legal Description of Property: LO I— 2- C 5� UP/ 2" 4/ V . <br /> Section#: 126 Town#: 1/0 N Range#: / W Town of. 6 44/1 <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* c4 <br /> Tax ID#(1-5 digit number; found on tax statement): <br /> l31.1zq ° <br /> C7 <br /> Proposed Use of Structu�re/Additi n: �j 1. 0111-Q- -� <br /> Anticipated Start Date:I V p6- lj� 7tu (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractors t f=.$ CO(ti.5W�G1.t. 1 Sewer Installer-U S �,[s.k 7 goo <br /> CA <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY rriz Q <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> 61 Ve/- 7‘ .eX66ei 4e1090,14-c low //till-z3-6 . <br /> ri <br /> CA <br /> m GG <br /> H <br /> Fee Rec: 3 To <br /> ° Check#: I V 7 a <br /> z <br /> r <br /> -C <br /> x <br /> m <br /> �� ,L <br /> J/Date of staff site visit: 1-9 ' Init'als of site aff: /// v <br /> �� �APPROVED BY LAND SERVICES OFFICIAL: DATE: � z . n <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF CD CD .--ig_ 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT :�C Q c <br /> Pagelof5 _`� <br /> Burnett County, WI Land Use Application—Rev 12/2023 �� JJ <br />