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• <br /> LAND USE PERMIT APPLICATION — Burnett County, WI a r <br /> b <br /> Applicant Complete All Sections Below This Line 0' ' <br /> CD i <br /> Permit Types and Fees(Please,check appropriate boxes), <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 S U` O <br /> ,Accessory Structure(Garage,Shed,etc.)360.$1SO Addition/Alteration to Accessory Structure $150 --c:, FD <br /> D <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 C4 , / <br /> o \/ <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 < <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 o <br /> $500 <br /> Filling/Grading $150 Boathouse R <br /> t. <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 �� <br /> i. \ <br /> -After-the-fact permits(permit acquired after constructionnas oegun)may cost up to three times the normal fee. <br /> *N -After-the-fact <br /> •Communication Towers,Camping Permits igns require a uon form;see corresponding application,and fees. �� <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 0 <br /> z <br /> Property Owner's Naine: ,V I Cl/ ( 'PG 'Qe G(,o GLc'*e c - `iF — r° <br /> ( Nb, , Dc1�G5r" , <br /> Property Owner's Mailing Address: 6 �� �. Like, `: ,A As w n <br /> City State Zip ° �' k <br /> Property Site Address: 7�Da &G ' � -70 o y <br /> Contact's Telephone Number: <br /> i <br /> Cn <br /> Contact's Email: CT <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N b <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov 0. °Q <br /> ao <br /> Legal Description of Property: L / o <br /> Section#: 33 Town#: 39 N Range#: I ( , W Town of: f - °F� �' <br /> *Attach additional page if needed for lengthy description OR attacha copy^- of the deed OR attach tax system property page.* <br /> Tax ID#(1-5 digit number; found on tax statement):' F-tt�3 (— 126 6& 1 Ii <br /> 6 <br /> Proposed Use of Structure/Addition: tax 24 $hp ,.i <br /> Anticipated Start Date: (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: ) i ,N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: G <br /> 0 Aid- 710 We, uSee AY' Ildwlctki Nab/,7�4 ?4,;4 <br /> A.,,,//-, be y 14 e m-teil 71P 4-- ',rya y <br /> Fee Rec:5_0(3._, <br /> ° Check#: <br /> r- <br /> r- <br /> < <br /> 2 ;"0 Y .f/2•34 <br /> � m t J <br /> D e o staff site visit: � �z� Initials of site visit staff: �j// o r— <br /> [[[ /// <br /> APPROVED BY LAND SERVICES OFFICIAL: 32- <br /> DATE: i,(67z,41f > Q '17 e <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF a <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT N <br /> n <br /> Page 1 of 5 r—==1 <br /> Burnett County, WI Land Use Application —Rev 12/2023 <br />