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LAND USE PERMIT APPLICATION —Burnett County, WI <br /> Applicant Complete All Sections Below This Line t,. <br /> Permit Types and Fees:(Please,check appropriate boxes) a <br /> C7 <br /> Dwelling/Principal Structure $300 _ Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 o <br /> Accessory Structure(Garage,Shed,etc.) $150_ Addition/Alteration to Accessory Structure $150 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 Q� , <br /> / Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 I', <br /> i/ Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 <br /> 0' <br /> Filling/Grading $150 Boathouse $500 <br /> w 110 <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 /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. `D <br /> it <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o r <br /> z <br /> o • <br /> Property Owner's Name: 1=�R.tcKSor,1 COMMt:12c.t A 1L t L—L.C. o W <br /> n. rt <br /> Property Owner's Mailing Address: Pa & c (cP-I \IVEB2ce \nll s`f893 Tr. <br /> , <br /> T1iE Rtnt,E. C1kM lr pc,Rou� J City State Zip ° E ` <br /> Property Site Address: 7729 tPRc sPECT 4WEl OA LT'1/ Z., ..IAm 6�Ay t W I 5483o o 0N <br /> Contact's Telephone Number: 366t&Rieth'rl4UX. 167�3—3�^k 07Z 0. <br /> sl <br /> Contact's Email: :-if'0.bj,Ae..-c].0Yc.77 z"1 M al L.CpM IN . <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N .ti <br /> legible and your email provider will accept emails from the following addresses: @BuettCounty.org and z 0°rn <br /> @BurnettCountyWl.gov 026-T'-lo.4-RICoiNI SJBDtv(6coi1: ViLLA(TE of Yelitm 1. KE cm <br /> ACS*6Sca•S PLA-r 140-1- 3 csNt v23 97e (*3rz 7) P <br /> Legal Description of Property: t`FMc-q ►.csr 8 * PRT Lorr 9 BLk I q. N <br /> Section#: Town#: N Range#: W Town of:13cti,LcuAct <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* i k <br /> Tax ID#(1-5 digit number;found on tax statement): 327 ZS <br /> --I LA <br /> Proposed Use of Structure/Addition: 11f=GK► r <br /> Anticipated Start Date: /IftPtki-J un1E 2i4 (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: .E ie tr1 ELAN Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY Po <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> z Fee Rec: /c 5 <br /> v <br /> Check#: 1 Q(Q3 <br /> m <br /> r <br /> a <br /> z <br /> L i' m _�J <br /> Date of staff site visit: 5l?12� Initials of site 'sit staff: 'i-r cn <br /> APPROVED BY LAND SERVICES OFFICIAL4 DATE: 511 Z0Z7 r. <br /> ao <br /> .-;,-4 g <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a <br /> 4 l7 O G''_ <br /> N CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT a . C <br /> Page 1 of 5 _ [i1 <br /> Burnett County,WI Land Use Application—Rev 5/2023 C <br />