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LAND USE PERMIT APPLICATION -Burnett County, WI a 3b <br /> N lJ <br /> Applicant Complete All Sections Below This Line g. co A <br /> O. <br /> Permit Types and Fees(Please,check appropriate boxes) d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 flicc W <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 \ ._ <br /> X, 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 5 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 �' <br /> M <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100+ • 'I mil' <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. `. Z <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 /> h _ o <br /> Property Owner's Name: k ,r( 0..fvi L)e,b-0�., E r i e on Q kA <br /> §. <br /> Property Owner's �Z C <br /> Mailing Address: ) wood&Ale, N1 I.0 ivy.h H Li 55:10( E. 0 p <br /> y_.City State�j Zip E <br /> p <br /> Property Site Address: 29I3 1 E . 1�Q,11QI.1)'.i vex-1 occ . )1\bAc w 1 52 SD z o y <br /> 1� g <br /> Contact's Telephone Number: 501 3'12- 41111 0r � —59-11 b <br /> Contact's Email: Kw\r Er\C,I son @q'('C10►,\ or arntr I cxso 0 cAmcc, 1 . ton <br /> **If staff has a question about this application,''du will be contacted via email. Make surf our email address is <br /> legible and your email provider will accept emails from the following address: nurnettCountyWI.gov <br /> /� d tV , <br /> Legal Description of Property: j�O.C'a,U.fl S l�1 V{� I rl{S -0�' <br /> Section#: 7 Town#: 10 N Range#: /6 W Town of: O k 4 L 4 AI p <br /> 5' <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* a, <br /> L� 1 Q o <br /> Tax ID#(1-5 digit number,found on tax statement): 14 2.3 J 1 w jA I d <br /> Proposed Use of Structure/Addition: Shed,, S-'17`C e_ m71 ( space. w 14,h el-.e6 i c' i I� Q <br /> Anticipated Start Date: M0. \ ) a a l-{ (Home/Ca n;Commercial Business;Bedroom Deck;etc.) �- <br /> or O 'Pr inevt r Ins �-tJoc+h t�oo� au+dam c s►, o <br /> Building Contractor: e� er Installer: ____ W <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY :EAA Z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> D met-+ a,� -( c s < s- <br /> Co <br /> CA <br /> Co <br /> O I\1(4 -O IX Ukd `lam' kuumaii 4 Fee Rec: `5T <br /> 44 <br /> ° Check#: 19.25 <br /> Jo <br /> /�t� Co N <br /> Date of staff site visit: 5/l�` �1 Ink" s of site vi 't staff: (l-+ 4 f Q › <br /> m <br /> APPROVED BY LAND SERVICES OFFIC DATE: 6 2O2 < - t <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF -0 <br /> 3 2 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 J <br /> Burnett County, WI Land Use Application- Rev 04/2024 <br />