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b <br /> s LAND USE PERMIT APPLICATION — Burnett County, WI KK r <br /> a <br /> ►ti <br /> Applicant Complete All Sections Below This Line 0' c <br /> (9 1 <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 O <br /> x Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 <br /> M <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 ,- e <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o it, <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 0 le <br /> Filling/Grading $150 Boathouse $500 <br /> up <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <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. g' <br /> z <br /> 0 <br /> Property Owner's Name: ciictvt..it _y\,t 9.. c-'(!,}-►-1,'F; L( ,�, a W , <br /> Property Owner's Mailing Address: W V 11�- p GNU f��' '1�y �1j�� w, W <br /> City State Zip ° 4 —� <br /> Property Site Address: "S4av-,,v' <br /> Contact's Telephone Number: k 1-4\13- a -a,1 a <br /> r\ 1 ,l n Il o <br /> Contact's Email: h- Wt,L'v l t2 `, a�hnAA 1 I--I&O it r� w <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is V\ <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWl.gov V °O On <br /> CIO LCr I �.S%V\V .4 )1)'7 d o 0 Legal Description of Property:4 Q <br /> Section#: ICI Town#: I N Range#: \ W Town of: ��l J. w <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* C4 <br /> ll �O i <br /> Tax ID#(1-5 digit number; found on tax statement)'{y 1; � .� � <br /> Proposed Use of Structure/Addit'on �^ -- -3 VI N <br /> Anticipated Start Date: f✓\ i RIi (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) (_.. <br /> z L' c^ (3) <br /> Building Contractor: '1 Sewer Installer: y 3 <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: zpo <br /> v <br /> 0 tYlke,-1- ctAA %-frioauk3 . <br /> / ND-1- 0 �2 US�e d TDB V►U.►'�'10�-t'\ Y�i G, a <br /> Fee Rec./.„..„-N) <br /> °z Check#: //Q/ <br /> r <br /> m <br /> 2 <br /> < <br /> V r� 1 <br /> r�,I I o <br /> Date of staff site visit:5I ��2o2y Initials of site visit staff: d `` ito E <br /> -7/, N ?+c0 <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: I� ZOG7 �_ N = co <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF 0-M = it U <br /> U <br /> al Si <br /> SIGNED PERMIT <br /> APPLICATION IN PLAIN SIGHT m <br /> as <br /> Page l of 5 <br /> Burnett County, WI Land Use Application—Rev 04/2024 ' ' ' <br />