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r .. <br /> . - LAND USE PERMIT APPLICATION — Burnett County, WI a <br /> Applicant Complete All Sections Below This Line a' <br /> CD I <br /> Permit Types and FeesIPlease,check appropriate boxes)' d <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 i ( " <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 1 \OJ`/ <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 n <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> no 011, <br /> VDeck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 i, <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o r <br /> Filling/Grading $150 Boathouse $500 <br /> cA <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> w <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. `. <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 v <br /> o • <br /> Property Owner's Name:_ �'Ytdl✓�c,.1 __ 1-1__\P, ' 1 <br /> oIlip <br /> / oa. <br /> Property Owner's Mailing Address: .SZS aoarc/n,ar) 5 '. Off nl / b.) rn� 1 0 n <br /> City State Zip vD <br /> Property Site Address: IL qZ L,P A-ccess R.d S PIVV (n/i 'S U'g° I o <br /> Contact's Telephone Number: Z Vag.3� ` e <br /> d <br /> Contact's Email: ect,gi€C.re/S-1'C-04+4ie.- Pi Mq t I. .-orn <br /> ro <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N -o <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov z fig <br /> ao <br /> Legal Description of Property:Psi- C, CSY" V' ( p La' (i P &.o i 1.'0 1 .5) d N <br /> Section#: 13 Town#: 3q N Range#: P4 W Town of: (DVS k ff. <br /> 1 " <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* cn <br /> Tax ID#(1-5 digit number; found on tax statement): I J 41 .2i10 W 3 o <br /> I <br /> Proposed Use of Structure/A di ion: 2ervte,( C.a.b s n beck- -3 <br /> Anticipated Start Date: S / (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) ! ` <br /> W C <br /> Building Contractor: ba vet, f�u he- Se.„(-P Sewer Installer: N/A- DI �q C. <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY trl <br /> p zx <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> /s e?f-- /5 7a f e4 ouS rDW u9t> �iS I C-j'rv, /jL, , <br /> 00 CCm. Gf U DC -x sP t- e‘ le i'F � ref a„,e, tri <br /> Q per u^1'7: Fee Rec: /c <br /> ° Check#: /2 (O f <br /> z <br /> r <br /> z <br /> rt <br /> Date of staff site visit: 5/4-/�Z7' Init' is of ite visit f: ;47--- <br /> � i <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE:: -CA ZV a tr: <br /> b a.' llttl] <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF l g 0 <br /> IraSIGNED PERMIT APPLICATION IN PLAIN SIGHT o o <br /> Page 1 of 5 3 4:- <br /> cp [MI <br /> Burnett County, WI Land Use Application—Rev 12/2023 <br /> J <br />