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LAND USE PERMIT APPLICATION — Burnett County, WI ir <br /> . b <br /> Applicant Complete All Sections Below This Line o ' <br /> Permit Types and Fees(Please,check appropriate boxes) n <br /> C7 <br /> Dwelling/Principal Structure _$300 Addition/Alteration to Dwelling/Principal Structure $200 W <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 � O <br /> i!' Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 CN a <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> 0 [, <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> Filling/Grading $150 Boathouse $500 cn �` <br /> a <br /> 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. i. Q <br /> a <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. a =' <br /> z <br /> o , <br /> Property Owner's Name: i�(�N A gei-1'n)1 C I-��e,v 1d e/l G o — oQ l <br /> 0 <br /> Property Owner's Mailing Address: 6405 rJ v 3 N'€`( /(L O n 0 O' iv n V fl t( W t 5N i3 0 0 n <br /> City State Zip ° �' <br /> Property Site Address: b ro )'J )`t 9 ins C RP � a ti A Y W I S &i v % < t <br /> o y <br /> Contact's Telephone Number: (li g-7o g- -o C aa <br /> a <br /> v V <br /> Contact's Email: b T,y h w i C,i-t-1 0f'`a' • C I <br /> **If staff has a question about this application,you Yin be contacted via email. Make sure your email address is b <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov °Q ‘,1 <br /> Legal Description of Property: v M <br /> Section#: a-7 Town#: 90 N Range#: I(i W Town of: 6 A Y.1.6 pj 'i' N <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* <br /> W <br /> Tax ID#(1-5 digit number; found on tax statement): 0 <br /> • <br /> Proposed Use of Structure/Addition: el e. r 0 t? -, W <br /> Anticipated Start Date: /M IC) fliVAl—ERil ,r /Il/ ome/Cabin;Commercial Business;Bedroom;Deck;etc.) ,_J <br /> ���� s rC <br /> Building Contractor: b EMO 4 c o ✓e-A (.{_e tlwer Installer: /VIA 7 0 g <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS.ONLY a z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: o <br /> U, <br /> be-4- oa.t SeiriakJ--S < c <br /> m <br /> c_ to \Q . \)5 e d -for ll.kxx> rk I\alai t S.+1)rrAV o()l y c. <br /> w <br /> Fee Rec:/h,0 <br /> �sl � ° Check#: �3y�j <br /> 01Stpyic dank WI _ivbe Se(.c,-red tit a lode aidr,�ia I✓1 6�`'l <br /> x <br /> m <br /> ED <br /> Date of staff site visit: 5-/ 0 ` ` Initial of site visit staff: L� v <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: J ga 3 0 D �I <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF <br /> m m NInd <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT Do o <br /> -. . ® Q <br /> Page 1of5 g <br /> Burnett County, WI Land Use Application-Rev 12/2023 LL <br />