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LAND USE PERMIT APPLICATION — Burnett County, WI s <br /> Applicant Complete All Sections Below This Line g' <br /> CD I <br /> Permit Types and Fees(Please,check appropriate boxes) 1.--, <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 0 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 g <br /> Accessory Structure(Garage,Shed,etc.) c42�0 Addition/Alteration to Accessory Structure $150 �, <br /> iAccessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 <br /> eY <br /> Filling/Grading $150 Boathouse $500 <br /> w <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 P. <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. g <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. ,. ".. <br /> J. <br /> 7" <br /> Property Owner's Name: `. f �, .71 <br /> c 1 •1l' <br /> � 5� s c ..0 <br /> Property Owner's Mailing Address: , 3,� 1/f Yn f���/Ll 1 i' <br /> (1 /I U< <�� n ,. r <br /> • City State Zip E -C (.� <br /> Property Site Address: le ii ,5�j ui� �{:� bLI Y 5�3 c <br /> Contact's Telephone Number: 2 I e ,-- 3 llt 7c 7 a. <br /> /9y� 1 14] x1 Id if& , 1ri Contact's Email4 <br /> CD <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N ON <br /> legible and your email provider will accept emails from the foil wing address: @BurnettCountyWl.gov o °° <br /> Legal Descripf n of Property: , 5 i,,cek . <br /> Section#: ' Town#: Ii N Range#: / 5— W Town of: '--- ijL' 1 S Sg. <br /> rN <br /> *Attach additional page if needed for lengthy description OR attach a copy of thzelee deed Ito attach tax system property page.* zn -L <br /> H V <br /> Tax ID#(1-5 digit number; found on tax statement): 2}Q 226417 N a <br /> p� C7 <br /> Proposed Use of Structure/Addition: /v e -i l�► <br /> Anticipated Start Date: ome/Cabin;Commercial Business;Bedr m;Deck;�gtc �� ' [ <br /> e_ 4 q rj h ' C t° vi,, o -c t^ <br /> BuildingContractor: 1/�/ Sewer Installer: <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY triz <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: x <br /> 0 met+ au ��4s c <br /> (&)Ck be. ltStd -iv tiwrn.axi MA-la-f-iv) 1 S- `id-` oft1i r, •��,,,,��,��' Fee Rec:S7l.�.+ <br /> 2 Check#:6514Z <br /> ni <br /> ni <br /> ---/z0/..) <br /> vi <br /> Date of staff site visit: L-I 11 Ini 'a1s of site visit staff: vt-+VI( r"vi <br /> m <br /> �7�f � <br /> APPROVED BY LAND SERVICES OFFICIAL: G DATE: 5 3 I'ZOG - Yo p0 m M <br /> 1 <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF y <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT �� N <br /> z <br /> Page 1 of 5 = <br /> Burnett County,WI Land Use Application—Rev 04/2024 Lc., JJ 1 <br />