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LAND USE PERMIT APPLICATION—Burnett County, WI , <br /> b <br /> N <br /> Applicant Complete All Sections Below This Line o• Fi �'A-. <br /> Permit Types and Fees(Please,check appropriate boxes) c �► <br /> C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 2. v <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 `� p <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 Eco <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 n 97 _� <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 <° ., <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 r- 3 <br /> 0 <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 5. <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. `' <br /> ro <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. ,T, 2. i''' <br /> z <br /> 0 <br /> Property Owner's Name: -bIYh PrivN. 7 ta M U+ �j <br /> Mailing 1 t C�"""�'� A NaC4-1 k `.G/-. V I -CC 1� a c� r% <br /> PropertyOwner's Address: 0 I�t`;'w�iiC N4 I-�Ir j �. � <br /> 1Cit State Zip <br /> Property Site Address: 2 0 L 2_ 1.4.0 J612- ci. c3 Z < - i <br /> Contact's Telephone Number: 22C\ _t c-r. e 1e•-- li 1 5 itC1) • 5 7 34U <br /> d ; <br /> Contact's Email: C l CGS 5 t , t/e-S <br /> **If staff has a question about this application,you will be contacted rail. Make sure your email address is N ro <br /> legible and your email provider will accept emails from the following address: (BurnettCountvWl.gov 5 °' <br /> r. <br /> Legal Description of Property: VT-- L o G <br /> EL 0Q. <br /> Section#: 2 (p Town#: 11-N Range#: { 0 W Town of:� —4 kJ)._ <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* cil.� l O X <br /> Tax ID#(1-5 digit number;found on tax statement): 3 4o <br /> Proposed Use of Structure/A dition: r GC '>-, C .) <br /> Anticipated Start Date: me Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: 3`Q f L/ ►✓)it-,... Sewer Installer: t��n — �` <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ° J^ <br /> z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z po <br /> " M OJT bo.1131,s <br /> — l ek kb Y., vs L& 6 \iiww,y. \no..\,:stico ANC <br /> -rituetp CA r fib Ql eN► te...t.1 0 r I't1MIJv `D� C" k � n, Fee Rec:�',� aD <br /> —"- u Z Check#: D/354 <br /> G13Ji <br /> Date of staff site visit: 512-2,12,024 Initials of site visit staff:` —d- l71 t a <br /> -5 137 <br /> APPROVED BY LAND SERVICES OFFICIAL: ys DATE: (13/7'4 . � <br /> /VW <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 3 -< <br /> CD - inn] <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 0 o <br /> Page 1 of 5 al'` <br /> Burnett County,WI Land Use Application—Rev 04/2024 0 <br /> = _ Fill <br /> L -J <br />